TY - JOUR
T1 - Ligation of the rectum with an extracorporeal sliding knot facilitating laparoscopic cross-stapling
T2 - a procedure revisited
AU - Bulut, Orhan
PY - 2013/11
Y1 - 2013/11
N2 - Abstract Background: Multiple stapler firings during distal rectal division were associated with unduly long stapler line and anastomotic leakage after laparoscopic rectal resection. A simple and relatively easy technique to perform a safe transection of rectum is presented. Materials and Methods: The extracorporeal ligation of the rectum just proximal to the cut end of the rectum before applying the linear stapling stapler facilitates the procedure and requires only a few firings of the stapler during the laparoscopic rectal resections. Results: Ten patients with a median age of 72 years underwent rectal transection with this technique. The procedure was performed with a single 60-mm cartridge in 3 patients, and two firings of the Endo GIA™ (Covidien LLC, Mansfield, MA) with a 45-mm cartridge were necessary for cross-stapling at the level of the pelvic floor in the remaining patients. There were no intraoperative complications. Postoperative complications were seen in 2 patients. Conclusions: This simple technique theoretically seems safer than the conventional approach and should be considered as an additional option for rectal transection.
AB - Abstract Background: Multiple stapler firings during distal rectal division were associated with unduly long stapler line and anastomotic leakage after laparoscopic rectal resection. A simple and relatively easy technique to perform a safe transection of rectum is presented. Materials and Methods: The extracorporeal ligation of the rectum just proximal to the cut end of the rectum before applying the linear stapling stapler facilitates the procedure and requires only a few firings of the stapler during the laparoscopic rectal resections. Results: Ten patients with a median age of 72 years underwent rectal transection with this technique. The procedure was performed with a single 60-mm cartridge in 3 patients, and two firings of the Endo GIA™ (Covidien LLC, Mansfield, MA) with a 45-mm cartridge were necessary for cross-stapling at the level of the pelvic floor in the remaining patients. There were no intraoperative complications. Postoperative complications were seen in 2 patients. Conclusions: This simple technique theoretically seems safer than the conventional approach and should be considered as an additional option for rectal transection.
U2 - 10.1089/lap.2013.0064
DO - 10.1089/lap.2013.0064
M3 - Journal article
C2 - 24117035
SN - 1557-9034
VL - 23
SP - 938
EP - 941
JO - Journal of laparoendoscopic & advanced surgical techniques. Part A
JF - Journal of laparoendoscopic & advanced surgical techniques. Part A
IS - 11
ER -