An anastomosis is a surgical procedure that is performed to connect two structures together inside the body. Anastomosis is most commonly used to secure upper and lower sections of the large intestine together after a middle section must be removed. Surgeons can also use the procedure following a major operation on the small intestine, esophagus, bladder, or bile duct. A specialized type is performed when a damaged area of an artery or vein must be bypassed or when blood vessels need to be connected to a transplanted organ. Recent advancements in tools and techniques allow the operation to be performed in a minimally-invasive fashion with the aid of an endoscopic camera.
In the past, patients who suffered from colon cancer or severe inflammatory bowel disease had few surgical options. When the entire colon had to be removed, the lower section of the small intestine was connected to a surgical opening in the abdomen. A colostomy bag outside of the body was used to collect waste, and the patient was rendered incontinent. Ileoanal anastomosis procedures eliminate the need for external colostomy bags and allow people to have normal, controlled bowel movements.
During an ileoanal anastomosis, the rectum is detached from the anal cavity and the colon is cut away from the ileum, the base of the small intestine. The surgeon then connects the ileum to the anal cavity with the aid of sutures and pins. The procedure is often performed endoscopically through several small incisions in the abdomen rather than a large open cut. A surgeon uses the endoscope to view the procedure on a monitor and to direct precision instruments.
Similar anastomosis procedures can be used when a part of the urethra, esophagus, or small intestine needs to be removed. Upper and lower sections are either stapled or sutured together to preserve normal functioning. Patients who have severely clogged arteries may be candidates for arterial anastomosis, which involves severing a damaged blood vessel at its base and attaching it to a donor vessel to bypass the blockage. Most arterial procedures take place in the chest and neck, though special operations can be used to correct blood flow problems in the legs, arms, groin, or brain.
All types of surgery have inherent risks, although skilled surgeons can minimize the chances of major complications. If the sutured area is not properly secured, it can become infected by bacteria. Excess bleeding or leakage of other body fluids is another common concern. Surgeons typically schedule frequent checkups following procedures to check for signs of complications.