Anastomotic concept – 120 degrees, 12 stitches
Because it is safe and orderly, the 120-degree anastomotic concept will be demonstrated first.
To achieve good closure of the anastomosis, we will use 12 stitches for this vessel diameter. The same concept, using nine and six stitches respectively, as well as the 180-degree concept, will be demonstrated later on. To match the vessel wall thickness and resistance in this model, we will use 9.0 suture.
This is the vessel’s circumference.
We virtually divide the vessel into three equal parts in order to place the first two stitches 120 degrees apart from each other on the upper aspect of the vessel.
The advantage of this technique is that the back wall on the far side of the vessel will droop, which helps avoid a backstitch that would tie front and back wall together, obstructing the lumen.
From now on, all stitches are placed exactly midway between their neighbors.
The third stitch is placed between the first two.
The fourth and fifth stitch are placed here and here, the sixth stitch is placed in the middle of the back wall and, as on the front wall, stitches seven through twelve are placed between their neighbors facilitating appreciation of distances between stitches by placing each stitch midway between its neighbors.