Laparoscopic Right Colectomy: Options for Ileocolonic Reconstruction

Abstract

Ileocolonic reconstruction during laparoscopic right colectomy can be performed extracorporeally or intracorporeally with completion of a side-to-side stapled or handsewn anastomosis (iso- or antiperistaltic), side-to-end stapled or handsewn anastomosis, and end-to-side or end-to-end handsewn anastomosis. The choice of anastomotic technique depends on the surgeon’s preference as well as the particular patient’s anatomy and intraoperative findings. While the literature does not suggest any major differences in outcomes related to these various anastomotic techniques, one difference relates to costs, with higher costs associated with additional stapler firing during stapled anastomoses. Moreover, since no major differences are reported in literature concerning the outcomes between intra- and extracorporeal anastomoses, many suggest decreased wound-related morbidity, better cosmesis, decreased postoperative pain, and incisional hernia rate with intracorporeal anastomosis.