Module 3: Summary

• Anastomotic healing requires good blood flow, but the colonic vascular supply can be compromised by resection.
• Collagen matrix in the submucosa is essential for structure and healing.
• Intestinal microbiota probably influence leaks, but more research is required for us to understand this process.
• The order in which resection and anastomosis is performed and its anatomical arrangement matter less than the need to ensure a good blood supply and the formation of a tension free anastomosis.
• The decision between creating a hand sewn or stapled anastomosis should be individualised to each patient.
• There are specific scenarios where stapled anastomosis is likely to be inappropriate.

The video below summarises a key learning point from this module, with a discussion about choice of handsewn versus stapled anastomoses: