Q) During a surgical skills assessment, you are asked to perform a hand-sewn intestinal anastomosis using a continuous, inverting suture that enters the bowel lumen. Which of the following suture techniques best fits this description?
#Theme from INI CET GI Mock test
A. Lembert suture B. Cushing suture C. Gambee suture D. Connell suture
Correct Answer: D. Connell suture
The Connell suture is a continuous, inverting, full-thickness suture technique. It is unique because:
The needle enters the bowel lumen, passing through the mucosa.
It is run parallel to the incision line.
It achieves inversion of the bowel edge, which promotes serosal healing but intraluminal suture exposure is a drawback.
Historically used for the inner layer of two-layer bowel anastomoses.
Comparison with Other Options:
A. Lembert suture
Seromuscular only, avoids the mucosa
Interrupted or continuous
Inverting, but does not enter lumen
B. Cushing suture
Continuous, inverting
Parallel to incision
Penetrates submucosa but not mucosa (no lumen entry)
C. Gambee suture
Interrupted, inverting
Passes through a small portion of mucosa
Designed to minimize mucosal eversion and reduce luminal exposure
