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In surgical jargon, to create an anastomosis is to join together two hollow organs (viscus), usually to restore continuity after resection, or to bypass an unresectable disease process. Historically such procedures were performed with suture material, but increasingly mechanical staplers and biological glues are employed. 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.

Anastomosis are typically performed on:

  • 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.
  • 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.

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.



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