A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an
arterial anastomosis is used in
vascular bypass and a
colonic anastomosis is used to restore colonic continuity after the resection of
colon cancer.
A surgical anastomosis can be created using suture sewn by hand, mechanical staplers and
biological glues, depending on the circumstances. While an anastomosis may be end-to-end, equally it could be performed side-to-side or end-to-side depending on the circumstances of the required reconstruction or
bypass. The term reanastomosis is also used to describe a surgical reconnection usually reversing a prior surgery to disconnect an anatomical
anastomosis, e.g.
tubal reversal after
tubal ligation.
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. A suture-free method for anastomosis of the colon to colon or rectum has been developed.[1][2]
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.[citation needed]
Fashioning an anastomosis is typically a complex and time-consuming step in a surgical operation, but almost always crucial to the outcome of the procedure.