Oversewing of cystogastrostomy

The posterior common cyst/gastric wall is oversewn ("reefed") with running 3-0 silk suture. One suture is run from 3o'clock to 9o'clock and tied, the other suture is run from 9 o'clock to 3 o'clock; this avoids a "pursestring" effect on the opening and allows the cyst to communicate freely with the stomach.

The gastrotomy is closed in two layers; the inner, running 3-0 polyglyconate suture is placed in a Connell fashion to invert the mucosa and obtain hemostasis; the outer layer consists of interrupted 3-0 silk seromuscular sutures.

The abdomen is closed without drainage using running 1-0 polydioxanon for the anterior and posterior rectus fasciae for a subcostal incision and 1-0 polyglycolic acid for a midline incision.

The skin incision is closed with staples.

Oversewing Artery

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