Placing anchoring sutures
The anchoring sutures are being placed. The suture is passed through the abdominal wall, a seromuscular bite of intestine is taken, and the suture is then passed out of the abdomen. Four sutures are placed in a diamondshaped configuration, providing both
Construction of extracorporeal stapled anastomosis
Construction of an extracorporeal stapled anastomosis using a linear endoscopic stapler. The jaws of the stapler are being advanced into small enterotomies. Traction sutures help steady the bowel in position.
External view of exteriorized segment
External view of exteriorized segment of small intestine prior to resection. Note wound protector.
Subsequent dissection of mesenteric vessels
The small bowel segment chosen for resection has been suspended by traction sutures passed through the anterior abdominal wall. This facilitates subsequent dissection of mesenteric vessels and provides retraction without additional graspers or trocars.