Skip to main content

Advertisement

Log in

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

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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. 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.

    Article  PubMed  CAS  Google Scholar 

  8. Everett WG, Greatorex RA. Colonic anastomosis-suture or staple? Trop Gastroenterol. 1987;8:195–203.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  10. Darzi A, Super P, Guillou PJ, Monson JR. Laparoscopic sigmoid colectomy: total laparoscopic approach. Dis Colon Rectum. 1994;37:268–71.

    Article  PubMed  CAS  Google Scholar 

  11. Hellan M, Anderson C, Pigazzi A. Extracorporeal versus intracorporeal anastomosis for laparoscopic right hemicolectomy. JSLS. 2009;13(3):312–7.

    PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  17. Song S, Itawi EA, Saber AA. Natural orifice transluminal endoscopic surgery (NOTES). J Invest Surg. 2009;22(3):214–7.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tetsuo Ikeda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ikeda, T., Kabasima, A., Ueda, N. et al. Totally laparoscopic colectomy with intracorporeal anastomosis achieved using a laparoscopic linear stapler: experience of a single institute. Surg Today 42, 41–45 (2012). https://doi.org/10.1007/s00595-011-0003-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-011-0003-x

Keywords

Navigation