Gambee Appositional Intestinal Anastomosis

Intestinal resection and anastomosis (IRAA) is a common surgical procedure performed in veterinary practice. Inverting, appositional and everting patterns have been described. In veterinary medicine appositional patterns are technically easy and are very popular. When the intestinal wall is incised, the longitudinal muscle fibers in its wall spasm and retract. This allows the mucosal-submucosal intestinal layer to evert and roll over the incised edge of the intestine. Because of the everting mucosa, it is impossible to get a pure appositional closure when the wall is suture with simple interrupted sutures. The Gambee suture pattern is a modification of the Lembert inverting pattern that brings the everting mucosal-submucosal complex back into a pure appositional pattern. It eliminates the irritating and adhesion causing mucosal tags that often stick through the serosal edge of the anastomosis.