Totally intracorporeal laparoscopic colorectal anastomosis using circular stapler.
BACKGROUND
A number of surgical techniques for colorectal anastomosis have been described for laparoscopic left-sided colectomies. Due to the complexity of these procedures, open preparation of the proximal bowel for circular stapler anastomosis through a Pfannenstiel incision has become the gold standard. We report a new laparoscopic technique for totally intracorporeal colorectal circular anastomosis (TLCCA) using a circular stapler.


METHODS
Preliminary experience using TLCCA in three patients scheduled for laparoscopic left colectomies (two) and sigmoidectomy (one).


RESULTS
Side-to-end colorectal anastomosis through TLCCA was feasible in all patients scheduled for preliminary experience. Median time from anvil insertion into abdominal cavity to anastomosis was 14 (11-17) minutes. No postoperative complications were recorded.


CONCLUSIONS
Side-to-end anastomosis can be easily and safely performed using conventional circular stapler through TLCCA. TLCCA is performed using four laparoscopic ports without additional skin incision (except trocars incision) and allows the retrieval of surgical pieces through a specimen bag.
Bucher
Pascal
P
Visceral Surgery, Department of Surgery, Geneva University Hospital, 24, Rue Micheli-du-Crest, 1211, Geneva 14, Switzerland. Pascal.Bucher@hcuge.ch
Wutrich
Philippe
P
Pugin
Francois
F
Gonzales
Michel
M
Gervaz
Pascal
P
Morel
Philippe
P
D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000295:instrumentation / Q000379:methods*; D003106:Colon / Q000601:surgery*; D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome