Editing Small bowel resection


== Technique ==

* Run small bowel from ligament of Treitz to ICJ
* Identify segment to resect
* Open resection
** Set-up
*** Expose the bowel on a moist pad
*** Select limits of resection and make mesenteric windows adjacent to bowel
*** Score the serosa in a V shape through the superficial peritoneal layer only
***
*** Divide the deeper layer of mesentery
**** LigaSure
**** Artery clips/Roberts and 2/0 vicryl ties
*** Resection
**** Non-crushing intestinal clamps on the 'keep' sides with a single click 5cm away from resection margins, and Allen clamps on the 'specimen' side (angle them slightly to preserve perfusion)
**** Scalpel division of bowel, or just make enterotomy and stapled anastomosis
*** Anastomosis (sutured or stapled)
**** See separate topic under 'colorectal'
*** Close mesenteric defect and ideally place omentum over the anastomosis
** Closure

== Intra-op dilemmas ==

* Anastomosis dusky
** Resect a couple more cm and redo


For the anastomosis, see separate topic '[[anastomosis]]' under 'colorectal operations'
[[Category:Small bowel]]