ABSTRACT
The factors that are essential for a successful bowel anastomosis are classified as local factors, patient factors and surgical factors. The local factors include good blood supply, inverted anastomosis, accurate apposition with good size approximation, and tension-free. The patient factors include good bowel preparation, relief of distal obstruction, adequate resuscitation and maintenance of tissue perfusion and oxygenation, and good nutritional status. The surgical factors include avoidance of watershed areas, adequate resection with margins free from disease, adequate mobilisation of bowel, use of familiar technique with appropriate sutures, and prevention of stenosis. The methods used for bowel anastomosis are hand-sutured method and stapled method. Linear stapling device is used to create a side-to-side anastomosis. A small enterostomy is created close to the selected anastomosis site to allow the insertion of the separated stapler’s jaws. Circular stapling device is used to unite bowel end to end. The bowel ends are drawn over the anvil and the cartridge with a purse-string of Prolene.
