The steps of the anastomosis are shown. The first stitch was placed outside to in on the splenic vein side of the heel, allowing the back wall to be run overhand toward the surgeon. The final back wall stitch was placed inside to out in the renal vein and tied to one strand of the toe stitch. The front wall was then completed, again starting outside to in, and running overhand. The final stitch was tied to the remaining heel strand.
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