Intracorporeal Anastomotic Techniques for Sigmoid and Rectal Resections

Abstract

There are about one million colorectal surgeries done in the United States every year with about half of these surgeries being done in the conventional open surgery (OS) manner and the other half being done via minimally invasive (MIS) approaches. The majority of MIS approaches include laparoscopic and robotic surgery. There is little doubt that patients greatly benefit from MIS approaches as there is less pain and quicker recovery compared to open surgery. In our efforts to continue to improve patient outcomes, even less invasive techniques have been developed including the intracorporeal anastomosis (ICA) as it requires less mobilization and manipulation of the bowel and allows for smaller incisions and more freedom in choice of the location of the extraction incision. Additionally, when combined with natural orifice specimen extraction, the extraction incision can be eliminated altogether. Overall, the creation of an intracorporeal anastomosis can lead to even less pain, less short-term wound complications, quicker recovery, and, in the long term, less incisional hernia formation. The focus of this chapter is on ICA techniques for left-sided colorectal resections.