Colonic anastomosis using the valtrac biofragmentable anastomosis ring: a new and useful surgical technique in gynecologic oncology.
Patients with a primary malignancy of the female genital tract may present with the majority of their disease confined to the pelvis. Not infrequently, infiltrating contiguous extension of disease may involve the rectosigmoid colon, resulting in symptoms of partial obstruction. This presentation in the patient with an epithelial ovarian malignancy may represent a patient that can be adequately cytoreduced if a segmental resection of the rectosigmoid colon is performed. Following resection, the continuity of the lower GI tract can be restored by anastomosis of the proximal and distal ends of the colon. In our institution three patients explored for large abdominal pelvic masses required segmental resection of the rectosigmoid colon. In each patient the colonic anastomosis was performed using the valtrac biofragmentable anastomosis ring (V-BAR). None of the patients experienced any intraoperative complications, and postoperatively there was no evidence of any anastomotic leaks. The average time of return of GI function was 6 days and there was no prolongation of their hospital stay. Currently, with 3 months of follow-up no patients have reported any symptoms suggestive of anastomotic stricture. Although our experience is limited, we found that this technique can be performed much faster than traditional hand-sewn or staple techniques. We submit that in the presence of uncompromised colon, the V-BAR is a safe and effective new alternative for colonic anastomosis in gynecologic oncological surgery.
Department of Gynecology-Obstetrics, Henry Ford Hospital, Detroit, Michigan 48202.
M L
ML
Hicks
W
W
Kim
S A
SA
Jenkins
D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods*; D003106:Colon / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D008488:Medical Illustration; D013525:Surgical Instruments