Anastomotic Construction

William Forrest Johnston, MD, FACS, FASCRS

There is a particular art to surgical technique that is very challenging to capture in text. As a result, the nuances of operative decision-making are often discovered through our experiences, either on our own or in discussion with colleagues. The art of colorectal surgery is most obvious in our dissection and anastomotic construction. This edition of Clinics in Colon and Rectal Surgery aims to more clearly illustrate the thoughtful considerations that are involved in anastomotic construction. The goal is to provide insight into the experiences and thought processes of other surgeons with the overall goal of providing topics for thoughtful consideration that may benefit our patients. It should be said that this edition of Clinics in Colon and Rectal Surgery is not a “how to” guide for the perfect, leak-free anastomosis.

My overall hope is that this edition generates some discussion among our community regarding how and why we do certain techniques during surgery. This edition will cover ileocolic, colorectal, and coloanal anastomosis with special consideration, given to diverticulitis and Crohn's disease. Further, we will discuss technical aspects of gaining length for anastomosis, robotics, and intracorporeal anastomosis, along with options for off midline extraction and thoughtful use of fecal diversion. The authors all deserve thanks for their thoughtfulness and willingness to share their insights.

Publication History

Article published online:
02 November 2022