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This Concept Map, created with IHMC CmapTools, has information related to: intestinal resection, transection of bowel insure re-establishment mucosal apposition, re-establishment mucosal apposition consider when suturing the bowel, close, wrap with omentum close Change contaminated instruments and gloves before abdominal lavage and closure., Intestinal Resection & Anastamosis how? ligate and transect the arcadial vessels that supply the affected segment of intestine, Also ligate and transect the terminal arcade vessels on either side of the planned intestinal transection b. Transect the mesentery, leaving adequate mesenteric tissue to facilitate closure of the defect after completion of the anastomosis, ligate and transect the arcadial vessels that supply the affected segment of intestine a. Also ligate and transect the terminal arcade vessels on either side of the planned intestinal transection, close, irrigate wrap with omentum After thorough lavage and suction, loosely wrap the anastomosis site with omentum . Accurate placement of the mesenteric sutures is essential. If the mesenteric border is difficult to see clearly, preplace 2 or 3 single interrupted sutures., Intestinal Resection & Anastamosis requirements patient must have enough anesthesia for a less complicated and painless inra op procedure. pre-op expected to cover surgical preparation of patient , surgeon, assistants, and area of use., ligate terminal vessels move on to transection of bowel, Intestinal Resection & Anastamosis how? link with pictures, suture the mesenteric and antemesenteric borders how to suturing the bowel, Intestinal Resection & Anastamosis apparatus fingers /Doyen's forceps assistants gauze lab sponges mayo scissors needle holder suture material- 3-0 absorbable suture with taper point needle nonabsorbable suture material to close (skin) forceps gloves drapes gown saline syringes needles (anaestetic and analgesic drugs and material to give the / gas anesthetic machine., suture the mesenteric and antemesenteric borders test the suture line Before releasing the luminal occlusion, the integrity of the suture line can be tested by moderately distending it with an injection of sterile saline. If leakage is present upon gentle manipulation of the anastomosis, place an additional simple interrupted suture to close the gap. Close the mesenteric defect with simple continuous sutures, Intestinal Resection & Anastamosis why? Removing segments that are: Ischemic. Necrotic Neoplastic, Transect the mesentery, leaving adequate mesenteric tissue to facilitate closure of the defect after completion of the anastomosis c. The terminal vessels may need to be ligated blindly due to the presence of fat, test the suture line irrigate Irrigate and suction the abdomen with copious amounts of warm sterile saline to reduce contamination and warm the abdomen. If the affected area of bowel can be completely exteriorized and packed off, as described in step 2, then local irrigation of the repair away from the abdomen is performed.