Technique for instant stapling of the sigmoid mesentery and mesorectum in laparoscopic colorectal surgery

Surg Endosc. 2006 Nov;20(11):1778-9. doi: 10.1007/s00464-005-0630-7. Epub 2006 Sep 6.

Abstract

Background: Dissection of the mesentery of the distal sigmoid or rectum before transection with a linear stapler in laparoscopic colorectal surgery is time consuming, can cause irritating bleeding, and can harm the vascularization of the distal part of the bowel anastomosis.

Methods: A new linear stapling technique in laparoscopic colorectal surgery is presented. This technique is used to perform transection of the distal sigmoid or proximal rectum with a linear stapler by instant stapling of both the mesentery/mesorectal fat and the intestine instead of standard preliminary dissection. This technique was performed in a pilot study of 27 laparoscopic colorectal operations for benign or malignant disease.

Results: In none of the 27 patients was leakage of the anastomosis observed.

Conclusions: This new technique is safe and effective. It saves time, avoids troublesome dissection of the mesentery/mesorectum, which can cause bleeding or damage to the bowel, and preserves vascularization of the distal part of the anastomosis.

MeSH terms

  • Adult
  • Aged
  • Colectomy / methods*
  • Colon / blood supply
  • Colon / surgery*
  • Female
  • Humans
  • Laparoscopy
  • Male
  • Mesentery / blood supply
  • Mesentery / surgery*
  • Middle Aged
  • Pilot Projects
  • Rectum / blood supply
  • Rectum / surgery*
  • Surgical Stapling / methods*
  • Treatment Outcome