The uncertainty of perfect approximation of the mesenteric border of the intestine has, no doubt, been the greatest objection to the suture method of end-to-end intestinal anastomosis. Because of the apprehensive postoperative period, the ingenious button device of Murphy has been largely superseded by the suture method of Connell.
The last-named method seems to have proved most satisfactory in side-to-side intestinal anastomosis. The objections to the end-to-end anastomosis are first, as stated above, the difficulty of securing perfect approximation of the mesenteric border, and second, the awkwardness of the method, necessitating as it does, considerable practice on the part of the surgeon before it can be successfully performed.
To work from the inside of such a cylindrical body as the intestine, closed with no free ends, is at first a serious mechanical difficulty. The object of the Connell method, as of all others, is of course to secure an inversion of
TENNANT CE. A NEW CLAMP FOR END-TO-END INTESTINAL ANASTOMOSIS. JAMA. 1911;LVI(20):1445–1446. doi:10.1001/jama.1911.02560200013007
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