Technique for instant stapling of the sigmoid mesentery and mesorectum in laparoscopic colorectal surgery.
BACKGROUND
Dissection of the mesentery of the distal sigmoid or rectum before transection with a linear stapler in laparoscopic colorectal surgery is time consuming, can cause irritating bleeding, and can harm the vascularization of the distal part of the bowel anastomosis.


METHODS
A new linear stapling technique in laparoscopic colorectal surgery is presented. This technique is used to perform transection of the distal sigmoid or proximal rectum with a linear stapler by instant stapling of both the mesentery/mesorectal fat and the intestine instead of standard preliminary dissection. This technique was performed in a pilot study of 27 laparoscopic colorectal operations for benign or malignant disease.


RESULTS
In none of the 27 patients was leakage of the anastomosis observed.


CONCLUSIONS
This new technique is safe and effective. It saves time, avoids troublesome dissection of the mesentery/mesorectum, which can cause bleeding or damage to the bowel, and preserves vascularization of the distal part of the anastomosis.
Van Deurzen
D F P
DF
Department of Surgery, Sint Franciscus Gasthuis, Rotterdam, The Netherlands.
Mannaerts
G H H
GH
Lange
J F
JF
D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008643:Mesentery / Q000098:blood supply / Q000601:surgery*; D008875:Middle Aged; D010865:Pilot Projects; D012007:Rectum / Q000098:blood supply / Q000601:surgery*; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome