Laparoscopic anterior resection: new anastomosis technique in a pig model.
OBJECTIVE
Bowel anastomosis after anterior resection is one of the most difficult tasks to perform during laparoscopic colorectal surgery. This study aims to evaluate a new feasible and safe intracorporeal anastomosis technique after laparoscopic left-sided colon or rectum resection in a pig model.


METHODS
The technique was evaluated in 5 pigs. The OrVil device (Covidien, Mansfield, Massachusetts) was inserted into the anus and advanced proximally to the rectum. A 0.5-cm incision was made in the sigmoid colon, and the 2 sutures attached to its delivery tube were cut. After the delivery tube was evacuated through the anus, the tip of the anvil was removed through the perforation. The sigmoid colon was transected just distal to the perforation with an endoscopic linear stapler. The rectosigmoid segment to be resected was removed through the anus with a grasper, and distal transection was performed. A 25-mm circular stapler was inserted and combined with the anvil, and end-to-side intracorporeal anastomosis was then performed.


RESULTS
We performed the technique in 5 pigs. Anastomosis required an average of 12 minutes. We observed that the proximal and distal donuts were completely removed in all pigs. No anastomotic air leakage was observed in any of the animals.


CONCLUSIONS
This study shows the efficacy and safety of intracorporeal anastomosis with the OrVil device after laparoscopic anterior resection.
Department of General Surgery, Gazi University Medical Faculty, Ankara, Turkey.
Abdulkadir
A
Bedirli
Department of General Surgery, Gazi University Medical Faculty, Ankara, Turkey.
Deniz
D
Yucel
Gazi University Laparoscopic Surgery Education and Research Center, Ankara, Turkey.
Burcu
B
Ekim
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000601:surgery; D012809:Colon, Sigmoid / Q000601:surgery*; D004195:Disease Models, Animal; D005260:Female; D010535:Laparoscopy / Q000379:methods; D012007:Rectum / Q000601:surgery*; D013536:Suture Techniques; D013552:Swine
Anastomosis; Laparoscopic anterior resection; OrVil; Pig model