title: Endo-satinsky clamp for rectal transection during laparoscopic total mesorectal excision.
abstract: BACKGROUND
  We describe a technique of intracorporeal rectal transection using an endo-Satinsky clamp during laparoscopic total mesorectal excision.
  
  
  METHODS
  We use an abdominal approach through 5 trocars. The rectum and mesorectum are mobilized completely. A flexible trocar is placed at the site of a 12-mm right lower abdominal port after the trocar originally placed there is pulled out. The 12-mm trocar originally placed in the right lower abdomen is moved to the suprapubic site, in which a Pfannenstiel incision is anticipated. The endo-Satinsky clamp is inserted through the flexible trocar, and the rectum is grasped with the endo-Satinsky clamp just above the anticipated point of transection. The endostapler is introduced through the 12-mm suprapubic port and is positioned just distal to the clamp. The rectum is then transected. The transected bowel is resected extracorporeally. Anastomosis is completed intracorporeally by use of a double-stapling technique.
  
  
  RESULTS
  From February 2007 to March 2009, we performed low anterior resection with use of the endo-Satinsky clamp for 11 patients with rectal cancer (laparoscopic, 10 patients; robot-assisted, 1 patient). There were no operative complications or deaths. Mean operation time was 179.5 minutes (range, 120-265 min). The average number of cartridges used for rectal transection was 1.6 per patient.
  
  
  CONCLUSIONS
  The endo-Satinsky clamp is a useful device for rectal transection and irrigation. The use of this device makes it easier to place an endostapler just distal to the clamp and to transect the rectum in a more appropriate position.
authors.affiliation: Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sun Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Choi
authors.forename: Suk Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Kil Yeon
authors.initials: KY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D012371:Robotics; D013525:Surgical Instruments; D017792:Surgical Stapling; D016896:Treatment Outcome