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Totally Laparoscopic Low Anterior Resection for Lower Rectal Cancer: Combination of a New Technique for Intracorporeal Anastomosis with Prolapsing Technique

Background: Laparoscopically assisted low anterior resection is difficult even for experienced surgeons because of difficulties in selecting the appropriate transection line and completing anastomosis in the narrow pelvic space. The prolapsing technique resolves these problems. We combined our new t... Full description

Journal Title: Digestive Surgery February 2010, Vol.26(6), pp.446-450
Main Author: Akamatsu, Hiroki
Other Authors: Omori, Takeshi , Oyama, Tsukasa , Tori, Masayuki , Ueshima, Shigeyuki , Nishida, Toshirou , Nakahara, Masaaki , Abe, Takashi
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0253-4886 ; E-ISSN: 1421-9883 ; DOI: 10.1159/000239761
Link: https://www.karger.com/Article/Abstract/239761
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recordid: karger_sDSU2009026006446
title: Totally Laparoscopic Low Anterior Resection for Lower Rectal Cancer: Combination of a New Technique for Intracorporeal Anastomosis with Prolapsing Technique
format: Article
creator:
  • Akamatsu, Hiroki
  • Omori, Takeshi
  • Oyama, Tsukasa
  • Tori, Masayuki
  • Ueshima, Shigeyuki
  • Nishida, Toshirou
  • Nakahara, Masaaki
  • Abe, Takashi
subjects:
  • How I Do It
  • Laparoscopic Surgery
  • Rectal Cancer
  • Low Anterior Resection
  • Intracorporeal Anastomosis
  • Prolapsing Technique
  • Efficient Purse-String Stapling Technique
  • Medicine
ispartof: Digestive Surgery, February 2010, Vol.26(6), pp.446-450
description: Background: Laparoscopically assisted low anterior resection is difficult even for experienced surgeons because of difficulties in selecting the appropriate transection line and completing anastomosis in the narrow pelvic space. The prolapsing technique resolves these problems. We combined our new technique for intracorporeal anastomosis with this prolapsing technique and achieved a totally laparoscopic low anterior resection. Methods: After the total mesorectal excision, a semi-circumferential colotomy is made at the anterior colonic wall just proximal to the proximal transection site. The anvil of a circular stapling device, secured with a Prolene suture, is introduced via the colotomy. The suture is advanced anteriorly so that the center rod of the anvil penetrates the colonic wall. The colon is staple-transected at this point to secure the anvil on the proximal colon. The distal rectum is everted and pulled transanally outside the body using a grasping forceps inserted from the anus. Staple-closure and transection of the distal rectum is performed under direct vision. Anastomosis is established using the double-stapling technique. Results: Totally laparoscopic low anterior resections using this technique were performed for 7 patients with rectal cancer. There was no anastomotic leakage/stenosis. Conclusions: Our procedure can be performed easily, which enables surgeons to achieve minimal invasiveness compared with hybrid NOTES.
language: eng
source:
identifier: ISSN: 0253-4886 ; E-ISSN: 1421-9883 ; DOI: 10.1159/000239761
fulltext: fulltext
issn:
  • 0253-4886
  • 02534886
  • 1421-9883
  • 14219883
url: Link


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titleTotally Laparoscopic Low Anterior Resection for Lower Rectal Cancer: Combination of a New Technique for Intracorporeal Anastomosis with Prolapsing Technique
creatorAkamatsu, Hiroki ; Omori, Takeshi ; Oyama, Tsukasa ; Tori, Masayuki ; Ueshima, Shigeyuki ; Nishida, Toshirou ; Nakahara, Masaaki ; Abe, Takashi
ispartofDigestive Surgery, February 2010, Vol.26(6), pp.446-450
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subjectHow I Do It ; Laparoscopic Surgery ; Rectal Cancer ; Low Anterior Resection ; Intracorporeal Anastomosis ; Prolapsing Technique ; Efficient Purse-String Stapling Technique ; Medicine
descriptionBackground: Laparoscopically assisted low anterior resection is difficult even for experienced surgeons because of difficulties in selecting the appropriate transection line and completing anastomosis in the narrow pelvic space. The prolapsing technique resolves these problems. We combined our new technique for intracorporeal anastomosis with this prolapsing technique and achieved a totally laparoscopic low anterior resection. Methods: After the total mesorectal excision, a semi-circumferential colotomy is made at the anterior colonic wall just proximal to the proximal transection site. The anvil of a circular stapling device, secured with a Prolene suture, is introduced via the colotomy. The suture is advanced anteriorly so that the center rod of the anvil penetrates the colonic wall. The colon is staple-transected at this point to secure the anvil on the proximal colon. The distal rectum is everted and pulled transanally outside the body using a grasping forceps inserted from the anus. Staple-closure and transection of the distal rectum is performed under direct vision. Anastomosis is established using the double-stapling technique. Results: Totally laparoscopic low anterior resections using this technique were performed for 7 patients with rectal cancer. There was no anastomotic leakage/stenosis. Conclusions: Our procedure can be performed easily, which enables surgeons to achieve minimal invasiveness compared with hybrid NOTES.
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titleTotally Laparoscopic Low Anterior Resection for Lower Rectal Cancer: Combination of a New Technique for Intracorporeal Anastomosis with Prolapsing Technique
description

Background: Laparoscopically assisted low anterior resection is difficult even for experienced surgeons because of difficulties in selecting the appropriate transection line and completing anastomosis in the narrow pelvic space. The prolapsing technique resolves these problems. We combined our new technique for intracorporeal anastomosis with this prolapsing technique and achieved a totally laparoscopic low anterior resection. Methods: After the total mesorectal excision, a semi-circumferential colotomy is made at the anterior colonic wall just proximal to the proximal transection site. The anvil of a circular stapling device, secured with a Prolene suture, is introduced via the colotomy. The suture is advanced anteriorly so that the center rod of the anvil penetrates the colonic wall. The colon is staple-transected at this point to secure the anvil on the proximal colon. The distal rectum is everted and pulled transanally outside the body using a grasping forceps inserted from the anus. Staple-closure and transection of the distal rectum is performed under direct vision. Anastomosis is established using the double-stapling technique. Results: Totally laparoscopic low anterior resections using this technique were performed for 7 patients with rectal cancer. There was no anastomotic leakage/stenosis. Conclusions: Our procedure can be performed easily, which enables surgeons to achieve minimal invasiveness compared with hybrid NOTES.

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titleTotally Laparoscopic Low Anterior Resection for Lower Rectal Cancer: Combination of a New Technique for Intracorporeal Anastomosis with Prolapsing Technique
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Background: Laparoscopically assisted low anterior resection is difficult even for experienced surgeons because of difficulties in selecting the appropriate transection line and completing anastomosis in the narrow pelvic space. The prolapsing technique resolves these problems. We combined our new technique for intracorporeal anastomosis with this prolapsing technique and achieved a totally laparoscopic low anterior resection. Methods: After the total mesorectal excision, a semi-circumferential colotomy is made at the anterior colonic wall just proximal to the proximal transection site. The anvil of a circular stapling device, secured with a Prolene suture, is introduced via the colotomy. The suture is advanced anteriorly so that the center rod of the anvil penetrates the colonic wall. The colon is staple-transected at this point to secure the anvil on the proximal colon. The distal rectum is everted and pulled transanally outside the body using a grasping forceps inserted from the anus. Staple-closure and transection of the distal rectum is performed under direct vision. Anastomosis is established using the double-stapling technique. Results: Totally laparoscopic low anterior resections using this technique were performed for 7 patients with rectal cancer. There was no anastomotic leakage/stenosis. Conclusions: Our procedure can be performed easily, which enables surgeons to achieve minimal invasiveness compared with hybrid NOTES.

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