A novel laparoscopic technique for stapled colon and rectal anastomosis.
BACKGROUND
We present new techniques of stapling anastomosis at laparoscopic colorectal surgery with retrospective review of data.


METHODS
A triangulating stapling technique (T method) was performed in 101 laparoscopic colectomies. Adouble stapling technique (DST) with rectal division by a conventional linear stapler (Abd method) was used in 5 cases of upper/middle rectal cancers and subsequent eversion of the distal rectum from the anus (Ev method) was used for 4 low rectal cancers. Four hundred ninety-six colectomies and 280 rectal surgeries were reviewed.


RESULTS
Leakage was lower in the T group (0.5%, n=196) than in the hand-sewn group (3.0%, n=233). Leakage of the DST using a laparoscopic linear stapler (12.1%, n=91) was significantly higher than with conventional DST (2.1%, n=189). There was no leakage with either Abd method or Ev method. The T-method is acceptable after laparoscopic colectomy.


CONCLUSIONS
New methods of rectal division using conventional devices are expected to yield reliable anastomosis at laparoscopic rectal surgery.
Fukunaga
Y
Y
Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22, Miyakojima-Hondoori, Miyakojima-ku, Osaka 5340021, Japan. YosukeF@aol.com
Higashino
M
M
Tanimura
S
S
Nishiguchi
Y
Y
Kishida
S
S
Nishikawa
M
M
Ogata
A
A
Osugi
H
H
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000379:methods*