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Anastomoses: End to End

- Discussion:
- end to end anastomosis is usually begun with two corner sutures 180 deg
- these may be placed as simple sutures, or horizontal matress suture;
- w/ double ended vascular sutures, corner sutures are tied first, one needle from each corner is then used to run the suture line in a simple over and over fashion to middle of each side of anastomosis;
- there the ends of the two sutures are tied together, completing the anterior anastomosis;
- vessel ends are then rotated 180 deg by moving the vascular clamps, thus exposing the previous posterior half of the anastomosis;
- suture line is then continued in an identical fashion to complete anastomosis;
- if vessels to be joined are relatively small, eg. 2-5 mm in diameter, anastomosis may be enlarged by beveling the ends 45 deg in opposite directions