Friday, September 14, 2007

Small bowel resection

Mayo scissors to open rectus

Non crushing clamp at each end
single Artery forcep: on jaw through mesentery. Overap in a line then apply crushing clamp to specimen

Cut behind crushing clamp and arteries with scalpel to excise specimen then vicryl ties to arteries

3-0 PDS suture mesenteric border of specimen, leaving artery on short end.

Continuous suture one side to antimesenteric border, then pass artery through mesenteric window to expose other side then tie of suture

Reinforce with interrupted 3-0 PDS

Test for watertightness

2 Artery forceps on cut edges of mesentery (Hoffman style) then tie with 2-0 vicryl

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