title: New laparoscopic double-stapling technique.
abstract: BACKGROUND
  Laparoscopic surgery for colon cancer has been shown by several randomized, controlled trials to be an acceptable alternative to open surgery; however, laparoscopic rectal surgery has not been evaluated in a randomized trial. One of the most serious problems associated with laparoscopic rectal surgery are bowel clamping, irrigation, and transection of the rectum, and laparoscopic rectal surgery has not been as reliable as open rectal surgery.
  
  
  METHODS
  We present our new technique, the laparoscopic double-stapling technique, which eliminates these problems. This technique uses curved Doyen forceps introduced through the wound just above pubis symphysis for clamping the rectal wall at the anal side of the tumor. An endolinear stapler (length 60 mm) is inserted through the same wound, applied at the rectal wall parallel and caudal to the Doyen forceps, and transects the rectum under pneumoperitoneum. We used this technique for eight cases of rectal surgery.
  
  
  CONCLUSIONS
  The laparoscopic double-stapling technique provided secure bowel clamping and rectal irrigation. The number of cartridges used in laparoscopic double-stapling technique cases was not more than 2, with an average of 1.6 per patient. None of the laparoscopic double-stapling technique cases experienced major complications.
  
  
  CONCLUSIONS
  We consider that many cases of rectal cancer that are suitable for laparoscopic low anterior resection can undergo laparoscopic surgery by using this technique, which will improve the quality of rectal surgery.
authors: Department of General and Digestive Surgery, Kochi Health Sciences Center, Kochi, Japan. KGH03145@nifty.com
authors: Madoka
authors: M
authors: Hamada
authors: Yutaka
authors: Y
authors: Nishioka
authors: Yohei
authors: Y
authors: Kurose
authors: Takao
authors: T
authors: Nishimura
authors: Yoshihito
authors: Y
authors: Furukita
authors: Kazuhide
authors: K
authors: Ozaki
authors: Toshio
authors: T
authors: Nakamura
authors: Yasuo
authors: Y
authors: Fukui
authors: Toshikatsu
authors: T
authors: Taniki
authors: Tadashi
authors: T
authors: Horimi
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome