Anastomotic Construction

  • Steven R. HuntEmail author
  • Matthew L. Silviera


This chapter summarizes the various techniques for common abdominal and pelvic anastomoses. General principles of anastomotic construction are summarized, including a review of the basic anastomotic types, techniques, equipment, and common problems leading to anastomotic complications. Controversial issues such as treatment of mesenteric defects, anastomotic drainage, and fecal diversion are presented. This chapter contains detailed descriptions for the creation of simple and complex anastomoses. The rationale and creation of various fecal reservoirs are explained. Finally, troubleshooting techniques for various intraoperative complications are discussed.


Anastomotic construction Handsewn anastomosis Anastomotic drainage Fecal diversion Neorectal reservoir Anastomotic salvage 

Supplementary material

Video 9.1

Extracorporeal assessment of the left colon prior to anastomosis using indocyanine green (ICG) (MP4 130195 kb)

Video 9.2

Proctoscopic anastomotic view of a colorectal rectal anastomosis (MP4 260583 kb)

Copyright information

© ASCRS (American Society of Colon and Rectal Surgeons) 2019

Authors and Affiliations

  1. 1.Division of General Surgery, Section of Colon and Rectal Surgery, Department of Surgery, Barnes Jewish HospitalWashington University School of MedicineSt. LouisUSA

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