Ideal exeresis with immediate anastomosis protected by an endoluminal shield (Coloshield) was performed in a series of 14 patients with left colic lesions for which the classical treatment would have been exeresis without anastomosis. No post-operative anastomotic fistulas were observed; one case of secondary stenosis of the anastomosis was treated successfully by endoscopic dilatation. The results of this series suggest that this technique is a reliable method of internal intestinal by-pass which offers real progress by allowing left colon exeresis with immediate anastomosis even in case with unfavourable local conditions.