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New Laparoscopic Double-Stapling Technique

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  • Published:
Diseases of the Colon & Rectum

Abstract

Background

Laparoscopic surgery for colon cancer has been shown by several randomized, controlled trials to be an acceptable alternative to open surgery; however, laparoscopic rectal surgery has not been evaluated in a randomized trial. One of the most serious problems associated with laparoscopic rectal surgery are bowel clamping, irrigation, and transection of the rectum, and laparoscopic rectal surgery has not been as reliable as open rectal surgery.

Materials and Methods

We present our new technique, the laparoscopic double-stapling technique, which eliminates these problems. This technique uses curved Doyen forceps introduced through the wound just above pubis symphysis for clamping the rectal wall at the anal side of the tumor. An endolinear stapler (length 60  mm) is inserted through the same wound, applied at the rectal wall parallel and caudal to the Doyen forceps, and transects the rectum under pneumoperitoneum. We used this technique for eight cases of rectal surgery.

Results and Discussion

The laparoscopic double-stapling technique provided secure bowel clamping and rectal irrigation. The number of cartridges used in laparoscopic double-stapling technique cases was not more than 2, with an average of 1.6 per patient. None of the laparoscopic double-stapling technique cases experienced major complications.

Conclusion

We consider that many cases of rectal cancer that are suitable for laparoscopic low anterior resection can undergo laparoscopic surgery by using this technique, which will improve the quality of rectal surgery.

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Acknowledgement

The preliminary version of our LDST technique has been published in Japanese.27

Author information

Authors and Affiliations

  1. Department of General and Digestive Surgery, Kochi Health Sciences Center, Kochi, Japan

    Madoka Hamada M.D., Yutaka Nishioka M.D., Yohei Kurose M.D., Takao Nishimura M.D., Yoshihito Furukita M.D., Kazuhide Ozaki M.D., Toshio Nakamura M.D., Yasuo Fukui M.D., Toshikatsu Taniki M.D. & Tadashi Horimi M.D.

  2. Kochi Health Sciences Center, 52125-1 Ike, Kochi-city, Kochi, Japan, 781-855

    Madoka Hamada M.D.

Authors
  1. Madoka Hamada M.D.
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  2. Yutaka Nishioka M.D.
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  3. Yohei Kurose M.D.
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  4. Takao Nishimura M.D.
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  5. Yoshihito Furukita M.D.
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  6. Kazuhide Ozaki M.D.
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  7. Toshio Nakamura M.D.
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  8. Yasuo Fukui M.D.
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  9. Toshikatsu Taniki M.D.
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  10. Tadashi Horimi M.D.
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Corresponding author

Correspondence to Madoka Hamada M.D..

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Hamada, M., Nishioka, Y., Kurose, Y. et al. New Laparoscopic Double-Stapling Technique. Dis Colon Rectum 50, 2247–2251 (2007). https://doi.org/10.1007/s10350-007-9035-0

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  • DOI: https://doi.org/10.1007/s10350-007-9035-0

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