World Journal of Laparoscopic Surgery

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VOLUME 16 , ISSUE 2 ( May-August, 2023 ) > List of Articles


Stapled Side-to-side Colo-anal Anastomosis in Middle and Upper Rectal Tumors: A Modification in the Technique

Ashok Kumar, Shomnath Reddy

Keywords : Colo-anal anastomosis, Incomplete doughnut, Low anterior resection

Citation Information : Kumar A, Reddy S. Stapled Side-to-side Colo-anal Anastomosis in Middle and Upper Rectal Tumors: A Modification in the Technique. World J Lap Surg 2023; 16 (2):110-113.

DOI: 10.5005/jp-journals-10033-1572

License: CC BY-NC 4.0

Published Online: 20-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: The aim of reporting this technique is to show the new surgical method and its feasibility. Background: Stapled colo-anal anastomosis is preferred in laparoscopic and open anterior and low anterior resection (LAR). Placement of purse-string suture around the anvil in the colon is an important step. Failing to place these sutures properly can lead to an incomplete doughnut, which can further lead to an anastomotic site leak and a whole spectrum of complications thereafter. Technique: We adopted an innovative method, where we inserted an anvil through the specimen site of the colon and brought out its pin through the antimesenteric site of the colon just before the division. It ascertains a complete doughnut each and every time in a quick time. Conclusion: Stapled colo-anal anastomosis is an easy and quick method with equal safety as a handsewn method; however, failure of the purse-string suture is responsible for an anastomotic leak, which leads to short-term and long-term complications. This could be avoided by our adapted technique. Clinical significance: This paper describes our technique, which can decrease the incidence of colo-anal anastomosis leak and all the spectra of postoperative complications, most importantly, sepsis and anastomotic stricture.

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