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