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This is an interrupted inverting suture pattern that is occasionally chosen by some surgeons when trying to purchase friable tissue edges in hollow organ incisions (Figure 3.2). The needle is passed into the hollow organ wall perpendicular and about 5 mm from the edge, through the serosa, muscularis, and submucosa and exits 2 mm from the edge on the same side. Across the incision, the needle is passed through the serosa perpendicular and about 2 mm from the edge into the serosa, muscularis, and submucosa before exiting 5 mm from the cut edge. Next the needle is reversed and identical bites are taken in the opposite direction about 5 mm from the first bite sequence. The free suture ends are tied to complete the stitch.

Figure 3.2