A novel laparoscopic technique for stapled colon and rectal anastomosis
2003
We present new techniques of stapling anastomosis at
laparoscopic colorectal surgery with retrospective review of
data. A triangulating stapling technique (T method) was
performed in 101 laparoscopic colectomies. Adouble stapling
technique (DST) with rectal division by a conventional linear
stapler (Abd method) was used in 5 cases of upper/middle rectal
cancers and subsequent eversion of the distal rectum from the
anus (Ev method) was used for 4 low rectal cancers. Four hundred
ninety-six colectomies and 280 rectal surgeries were
reviewed. Leakage was lower in the T group (0.5%, n=196) than in the
hand-sewn group (3.0%, n=233). Leakage of the DST using a
laparoscopic linear stapler (12.1%, n=91) was significantly
higher than with conventional DST (2.1%, n=189). There was no
leakage with either Abd method or Ev method. The T-method is
acceptable after laparoscopic colectomy. New methods of rectal division using conventional devices
are expected to yield reliable anastomosis at laparoscopic
rectal surgery.
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