Abstract
The use of the circular stapler has enabled surgeons to perform very low anterior resections where previously abdominoperineal proctectomy would be performed for carcinoma of the rectum. The use of the roticulator or other linear stapler devices has facilitated these anastomoses and precluded the necessity for pursestring sutures, thereby reducing the incidence of incomplete tissue rings, which should reduce the risk of anastomotic leaks. One significant drawback to the roticulator, especially in the narrow male pelvis, is its application for very low lesions. In many cases the stapler cannot be forced deeply enough into the pelvis to allow for a sufficient margin below the tumor. PURPOSE; The purpose of this article is to report results of a prototype that applies a gasket that automatically fixes the rectum to the rod of the circular stapler. METHOD: To date the device has been used 22 times in 14 patients (8 patients had both limbs attached using the device, whereas 6 patients had only the rectal stump attached in this manner). RESULTS: All anastomoses healed without complication, all patients had complete donuts of tissue, and only two anastomoses had to be reinforced. CONCLUSION: The use of this device may facilitate stapling of very low anastomoses for carcinoma of the rectum.
Similar content being viewed by others
References
Dixon CF. Anterior resection for malignant lesions of the upper part of the rectum and lower part of the sigmoid. Ann Surg 1948;128:425–442.
Goligher JC, Lee PW, Macfie J, Simpkins KC, Lintott DJ. Experience with the Russian model 249 suture gun for anastomosis of the rectum. Surg Gynecol Obstet 1979;148:516–24.
Cohen Z, Meyers E, Langer B, Railton RH, Jamieson C. Double stapling technique for low anterior resection. Surg Gynecol Obstet 1983;26:231–5.
Redmond HP, Austin OM, Clery AP, Deasy JM. Safety of double-stapled anastomosis in low anterior resection. Br J Surg 1993;80:924–7.
Author information
Authors and Affiliations
Additional information
Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Orlando, Florida, May 8 to 13, 1994.
About this article
Cite this article
Gingold, B.S., Cooper, M.L. & Wallack, M.K. Ligation device assisting low anterior anastomosis. Dis Colon Rectum 38, 1322–1324 (1995). https://doi.org/10.1007/BF02049159
Issue Date:
DOI: https://doi.org/10.1007/BF02049159