The image shows resected specimen of ischemic gut. The patient presented in septicemic state with features suggestive of gut ischemia, for which resection of involved gut was carried out, followed by end-to-end anastomosis.
Stay sutures have been placed and tied. Two enterotomies have been made and the stapler is inserted into the two enterotomies. The bowel and gallbladder must be carefully positioned to fully utilize the entire length of the stapling device (by pulling the
For a short stricture, open the bowel longitudinally and close it transversely as shown.
The endoscopic linear stapler is used to divide the bowel at the distal resection margin.
Passing one of the dilators through the abdominal wall and into the lumen of the jejunum. Care is taken to pass the dilator just into the lumen of the bowel (under visual laparoscopic control), not far enough to risk posterior intestinal wall perforation.
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.