Surgery Today

, Volume 42, Issue 1, pp 41–45 | Cite as

Totally laparoscopic colectomy with intracorporeal anastomosis achieved using a laparoscopic linear stapler: experience of a single institute

  • Tetsuo IkedaEmail author
  • Akira Kabasima
  • Naoyuki Ueda
  • Yusuke Yonemura
  • Mizuki Ninomiya
  • Mako Nogami
  • Kyuzo Fujii
  • Kojiro Mashino
  • Hideya Tashiro
  • Hisanobu Sakata
Original Article



Laparoscopic colonic surgery is now widely accepted. We assessed the safety and effectiveness of using a total intracorporeal surgical strategy to perform intracorporeal functional end-to-end anastomosis with an endoscopic linear stapler to treat colon cancer.


Forty-three selected patients underwent elective laparoscopic colon resection for carcinoma. A total intracorporeal colon resection was performed in all patients, using a functional end-to-end anastomosis with an endoscopic linear stapler.


Good results were achieved in all 43 patients, none of whom required conversion to open surgery with extracorporeal anastomosis. There have been no intraoperative complications related to this technique and no instances of postoperative anastomotic leakage, intra-abdominal abscess, or wound infection.


Intracorporeal functional end-to-end anastomosis using a linear stapler can be performed safely and easily for the resection of any part of the colon. We consider it an effective modality for totally laparoscopic colon resection. Favorable results have been achieved by this method, particularly for small tumors, since natural-orifice transluminal endoscopic surgery remains a challenging method to perform.


Colon cancer Laparoscopic colon resection Intracorporeal stapled reconstruction 


  1. 1.
    Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–26.PubMedCrossRefGoogle Scholar
  2. 2.
    Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G. Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA. 2002;287:321–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Yamamoto S, Watanabe M, Hasegawa H, Kitajima M. Oncologic outcome of laparoscopic versus open surgery for advanced colorectal cancer. Hepatogastroenterology. 2001;48:1248–51.PubMedGoogle Scholar
  4. 4.
    Guller U, Jain N, Hervey S, Purves H, Pietrobon R. Laparoscopic vs open colectomy: outcomes comparison based on large nationwide databases. Arch Surg. 2003;138:1179–86.PubMedCrossRefGoogle Scholar
  5. 5.
    Reza MM, Blasco JA, Andradas E, Cantero R, Mayol J. Systematic review of laparoscopic versus open surgery for colorectal cancer. Br J Surg. 2006;93(8):921–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004;350(20):2050–59.Google Scholar
  7. 7.
    Nakamura T, Onozato W, Mitomi H, Naito M, Sato T, Ozawa H, et al. Retrospective, matched case–control study comparing the oncologic outcomes between laparoscopic surgery and open surgery in patients with right-sided colon cancer. Surg Today. 2009;39(12):1040–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Everett WG, Greatorex RA. Colonic anastomosis-suture or staple? Trop Gastroenterol. 1987;8:195–203.PubMedGoogle Scholar
  9. 9.
    Kracht M, Hay JM, Fagniez PL, Fingerhut A. Ileocolonic anastomosis after right hemicolectomy for carcinoma: stapled or hand-sewn? A prospective, multicenter, randomized trial. Int J Colorectal Dis. 1993;8:29–33.PubMedCrossRefGoogle Scholar
  10. 10.
    Darzi A, Super P, Guillou PJ, Monson JR. Laparoscopic sigmoid colectomy: total laparoscopic approach. Dis Colon Rectum. 1994;37:268–71.PubMedCrossRefGoogle Scholar
  11. 11.
    Hellan M, Anderson C, Pigazzi A. Extracorporeal versus intracorporeal anastomosis for laparoscopic right hemicolectomy. JSLS. 2009;13(3):312–7.PubMedGoogle Scholar
  12. 12.
    Bucher P, Wutrich P, Pugin F, Gonzales M, Gervaz P, Morel P. Totally intracorporeal laparoscopic colorectal anastomosis using circular stapler. Surg Endosc. 2008;22(5):1278–82.PubMedCrossRefGoogle Scholar
  13. 13.
    Akamatsu H, Omori T, Oyama T, Tori M, Ueshima S, Nakahara M, et al. Totally laparoscopic sigmoid colectomy: a simple and safe technique for intracorporeal anastomosis. Surg Endosc. 2009;23(11):2805–9.CrossRefGoogle Scholar
  14. 14.
    Ikeda O, Sakaguchi Y, Aoki Y, Harimoto N, Taomoto J, Masuda T, et al. Advantages of totally laparoscopic distal gastrectomy over laparoscopically assisted distal gastrectomy for gastric cancer. Surg Endosc. 2009;23(10):2374–9.PubMedCrossRefGoogle Scholar
  15. 15.
    McKenzie S, Baek JH, Wakabayashi M, Garcia-Aguilar J, Pigazzi A. Totally laparoscopic right colectomy with transvaginal specimen extraction: the authors’ initial institutional experience. Surg Endosc. 2010;24(8):2048–52.PubMedCrossRefGoogle Scholar
  16. 16.
    Gumbs AA, Fowler D, Milone L, Evanko JC, Ude AO, Stevens P, et al. Transvaginal natural orifice transluminal endoscopic surgery cholecystectomy: early evolution of the technique. Ann Surg. 2009;249(6):908–12.PubMedCrossRefGoogle Scholar
  17. 17.
    Song S, Itawi EA, Saber AA. Natural orifice transluminal endoscopic surgery (NOTES). J Invest Surg. 2009;22(3):214–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P. A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg. 1998;187:46–54 (discussion 54–5).Google Scholar
  19. 19.
    Grams J, Tong W, Greenstein AJ, Salky B. Comparison of intracorporeal versus extracorporeal anastomosis in laparoscopic-assisted hemicolectomy. Surg Endosc. 2010;24(8):1886–91.PubMedCrossRefGoogle Scholar
  20. 20.
    Park S, Chun HJ, Keum B, Seo YS, Jeen YT, Um SH, et al. Successful hybrid NOTES resection of early gastric cancer in a patient with concomitant advanced colon cancer. Endoscopy. 2010;42(Suppl 2):E1–2.PubMedCrossRefGoogle Scholar
  21. 21.
    Auyang ED, Vaziri K, Volckmann E, Martin JA, Soper NJ, Hungness ES. NOTES: cadaveric rendezvous hybrid small bowel resection. Surg Endosc. 2008;22(10):2277–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Flora ED, Wilson TG, Martin IJ, O’Rourke NA, Maddern GJ. A review of natural orifice transluminal endoscopic surgery (NOTES) for intra-abdominal surgery: experimental models, techniques, and applicability to the clinical setting. Ann Surg. 2008;247(4):583–602.PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2011

Authors and Affiliations

  • Tetsuo Ikeda
    • 1
    • 2
    Email author
  • Akira Kabasima
    • 1
  • Naoyuki Ueda
    • 1
  • Yusuke Yonemura
    • 1
  • Mizuki Ninomiya
    • 2
  • Mako Nogami
    • 1
  • Kyuzo Fujii
    • 1
  • Kojiro Mashino
    • 1
  • Hideya Tashiro
    • 1
  • Hisanobu Sakata
    • 1
  1. 1.Department of SurgeryOita Prefectural HospitalOitaJapan
  2. 2.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

Personalised recommendations