•
Blood vessels: Arteries and
veins. Most vascular procedures, including all
vascular bypass operations (e.g.
coronary artery bypass),
aneurysmectomy of any type, and all solid
organ transplants require vascular anastomoses. An anastomosis connecting an artery to a vein is also used to create an arteriovenous
fistula as an access for
hemodialysis. •
Gastrointestinal (GI) tract: Esophagus,
stomach,
small bowel,
large bowel,
rectum,
bile ducts, and
pancreas. Virtually all elective resections of gastrointestinal organs are followed by anastomoses to restore continuity;
pancreaticoduodenectomy is considered a massive operation, in part, because it requires three separate anastomoses (stomach, biliary tract and pancreas to small bowel). Bypass operations on the GI tract, once rarely performed, are the cornerstone of
bariatric surgery. The widespread use of mechanical suturing devices (linear and circular staplers) changed the face of
gastrointestinal surgery. A suture-free method for anastomosis of the colon to colon or rectum has been developed. •
Urinary tract: Ureters,
urinary bladder,
urethra.
Radical prostatectomy and
radical cystectomy both require anastomosis of the bladder to the
urethra in order to restore continuity. •
Microsurgery: The advent of microsurgical technique allowed anastomoses previously thought impossible, such as so-called "nerve anastomoses" (not strictly an anastomosis according to the above definition), and operations to restore fertility after
tubal ligation or
vasectomy. Fashioning an anastomosis is typically a complex and time-consuming step in a surgical operation, but almost always crucial to the outcome of the procedure. ==See also==