Surgical anastomosis
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In surgical jargon, to create an anastomosis is to stitch together two cut ends of any hollow organ, usually to restore continuity after resection, or to bypass an unresectable disease process.
Anastomosis are typically performed on:
- Blood vessels: Arteries and veins. Most vascular procedures, including all arterial bypass operations (e.g. coronary artery bypass), aneurysmectomy of any type, and all solid organ transplants require vascular anastomoses.
- Gastrointestinal (GI) tract: Esophagus, stomach, small bowel, large bowel, bile ducts, and pancreas. Virtually all elective resections of gastrointestinal organs are followed by anastomoses to restore continuity; pancreaticoduodenectomy is considered a massive operation, in part, because it requires three separate anastomoses (stomach, biliary tract and pancreas to small bowel). Bypass operations on the GI tract, once rarely performed, are the cornerstone of bariatric surgery. The widespread use of mechanical suturing devices (linear and circular staplers) changed the face of gastrointestinal surgery.
- Urinary tract: Ureters, urinary bladder, urethra. Radical prostatectomy and radical cystectomy both require anastomosis of the bladder to the urethra in order to restore continuity.
- Microsurgery: The advent of microsurgical technique allowed anastomoses previously thought impossible, such as so-called "nerve anastomoses" (not strictly an anastomosis according to the above definition), and operations to restore fertility after tubal ligation or vasectomy.
Fashioning an anstomosis is typically a complex and time-consuming step in a surgical operation, but almost always crucial to the outcome of the procedure.
