title: Modified single stapler technique in anterior resection for rectal cancer.
abstract: Technical difficulties during colorectal surgery increase the complication rates. We introduce a modified single stapler technique for patients in whom technical problems are encountered while performing double stapler technique. Before pelvic dissection, descending colon is divided at minimum 10 cm proximal to the tumoral segment. Tumor specific mesorectal excision is performed and two purse string sutures are placed at the distal margin with an interval of 1 - 2 cm. After introducing a circular stapler via the anus, the distal purse string suture is tied around the central shaft of the stapler and the proximal purse string suture around the colonic lumen. After the resection is completed between the two sutures, the anvil shaft is connected to the central shaft and the stapler is closed and fired. None of the patients had an anastomotic leak. This technique may be a safe alternative particularly in patients with narrow pelvis and distal tumors.
authors.affiliation: Department of General Surgery, Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Soner
authors.initials: S
authors.lastname: Akbaba
authors.affiliation: Department of General Surgery, Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Pamir Eren
authors.initials: PE
authors.lastname: Ersoy
authors.affiliation: Department of General Surgery, Ataturk Training and Research Hospital, Ankara, Turkey.
authors.forename: Riza Haldun
authors.initials: RH
authors.lastname: Gundogdu
authors.affiliation: Department of Gastroenterology Surgery, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Ulas
authors.affiliation: Department of General Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Menekse
mesh_terms: D000368:Aged; D001003:Anal Canal / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D013528:Surgical Staplers; D013536:Suture Techniques / Q000295:instrumentation*