title: Reverse Transrectal Stapling Technique Using the EEA Stapler: An Alternative Approach in Difficult Reversal of Hartmann's Procedure.
abstract: The introduction of circular end-to-end stapling devices (CEEA OR EEA stapler) into colorectal surgery have revolutionised anastomotic techniques. The EEA stapler is generally regarded as an instrument that is safe, reliable, and simple to operate. Despite it's popularity, very little information is available regarding the technical difficulties encountered during surgery. The routine technique to perform an end-to-end circular colonic anastomosis is to introduce the instrument distally through the anus (transrectal/transanal approach) and attach it to the anvil which is purse stringed at the distal end of the proximal bowel to be anastomosed. Two cases of reversal of Hartmann's procedure for perforated diverticulitis are described in the present study, where difficulty was experienced while using the EEA stapler in the routine method. Hence, an alternative reverse technique which was used is presented.
authors.affiliation: Department of Surgery, MOSC Medical College, Kolenchery, Cochin, India.
authors.forename: Sanoop K
authors.initials: SK
authors.lastname: Zachariah
references.citation: World J Surg. 1981 Sep;5(5):735-7
references.pmid: 7331368
references.citation: Ann Surg. 1979 May;189(5):587-600
references.pmid: 443911
references.citation: J Med Biogr. 2001 Feb;9(1):16-9
references.pmid: 11177781
references.citation: World J Surg. 1982 Sep;6(5):525-30
references.pmid: 6753346
references.citation: Br J Surg. 1989 Aug;76(8):787-9
references.pmid: 2765828
references.citation: Dis Colon Rectum. 1989 Nov;32(11):998-9
references.pmid: 2806031
references.citation: Am J Surg. 1981 Sep;142(3):388-90
references.pmid: 7025670
references.citation: Dis Colon Rectum. 1981 Apr;24(3):215-6
references.pmid: 7227138
references.citation: Dis Colon Rectum. 1986 Jan;29(1):67-8
references.pmid: 3940811
references.citation: Ann Surg. 1979 Jun;189(6):791-7
references.pmid: 453950