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BOWEL ANASTOMOSIS ( overview ) SUDJATMIKO DIGESTIVE DIVISION – DEPARTMENT OF SURGERY DR SOETOMO GENERAL HOSPITAL SURABAYA 1st Surabaya Gastrointestinal and Emergency Surgery Surabaya, May 19 –20th 2017 INTRODUCTION • The word anastomosis comes from the Greek ‘ ana’ without , and ‘stoma’ a mouth. • The intestinal anastomosis is the surgical connection of separate bowel to form a continous chanel. • Worldwide intestinal resection and anastomosis performed over billion annually • Bowel anastomoses are common problem in both elective and emergency surgery • Various complication can be assosociated with anastomosis after the surgeries • The anastomotic methode and devices are invented with the purpose to perfect the result. HISTORY • Suture have been used for at least 4000 years ago. • Egyptian used linen and animal sinew to close wounds • In 1826, Antoine Lembert, serosal apposition • 1867, Joseph Lister concept of asepsis • Cushing andConnel continous inverting suture • In 1882,Halsted, idea that collagen in the submucosal layer was main factor responsible for the resistance of anastomosis • Halsted recommended single layer aposition anastomosis • 1892, Murphy Button was first popular anastomosis stapling prototype • In 1893 detected approximated 52 different technique intestinal suture • 1908, Humer Hultl (Hungary) and 1924, Petzinvented modern stapling • 1970 stapling introduce as bowel anastomosis • 1985, Thomas G Hardy, biofragmentable anastomotic ring (sutureless anastomosis) Chen C , Scandinavian Journal of Surgery 2012; 101; 238-240. Chellamani KP at al. J. Acad. Indus. Rev. Vol (12) May 2013 INDICATION • Restoration continuity following resection of bowel disease i.e - perforation - gangren - malignancy - radiation enteric - infection, stricture - benign condition, polip, intusuception • Bypass of unresectable bowel disease - advanced tumor causing luminal obstruction - metastatic disease • Congental anomalies - ie. Intestinal atresia • Bilio-pancreatic diversion
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