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A novel and simple technique to close the enterotomy after intracorporeal anastomosis in laparoscopic right hemicolectomy

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Abstract

We developed a new technique to reduce the length of the enteric defect to be closed during intracorporeal anastomosis in laparoscopic right hemicolectomy (LRH), also avoiding the need to suture the first part of the anastomosis in a deep space with an acute angle. From January 2017, after the ileo-colic anastomosis was completed, an additional stapler cartridge was applied starting at the colonic rim and including the small bowel part of the anastomosis. The isoperistaltic fashion of the ileo-colonic anastomosis was maintained. The remaining defect left to be closed was 2–3 cm. We compared the results of the novel technique with those of the ‘standard’ closure (full-length enterotomy). In the last 30 months, this technique was successfully used in 32 patients (Group A), compared with 33 patients (2012–2016) operated with ‘standard’ closure (Group B). Age, BMI and post-operative stage distribution were similar. The mean operative time was 175.2 min (± 36.7) in Group A and 165.9 min (± 42.5) in Group B (p = ns), with 53.1% and 27.3% of associated procedures (cholecystectomy, ovariectomy, etc.), respectively (p < 0.05). Overall morbidity rate was 28.1% and 30.3% (Group A vs Group B, p = ns), with no anastomotic bleeding/leak in either group. This technique, which simplifies the closure of the enteric defect after LRH with intracorporeal anastomosis is safe, reproducible and easy to learn. It might help more surgeons to perform a fully laparoscopic procedure in right hemicolectomy, offering the advantages of intracorporeal anastomosis to their patients.

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Authors and Affiliations

  1. Department of General Surgery, Azienda Euganea ULSS 6, Via Casa di Ricovero, 40, 35013, Cittadella, Padova, Italy

    Giuseppe Portale, Chiara Cipollari, Sabrina Pedon & Valentino Fiscon

  2. Department of Epidemiology, Azienda Euganea ULSS 6, Padua, Italy

    Luca Benacchio

Authors
  1. Giuseppe Portale
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  2. Chiara Cipollari
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  3. Sabrina Pedon
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  4. Luca Benacchio
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  5. Valentino Fiscon
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Correspondence to Giuseppe Portale.

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Conflict of interest

Drs. G. Portale, C. Cipollari, S. Pedon, L. Benacchio and V. Fiscon have no conflict of interest or financial ties to disclose.

Ethics

The study was conducted according to the Helsinki Declaration and patients gave their consent to have their data collected for scientific purposes. The study was approved by the local Ethics Committee of Padova (#4830/U6/20).

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Portale, G., Cipollari, C., Pedon, S. et al. A novel and simple technique to close the enterotomy after intracorporeal anastomosis in laparoscopic right hemicolectomy. Updates Surg 73, 1435–1442 (2021). https://doi.org/10.1007/s13304-021-01025-3

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  • DOI: https://doi.org/10.1007/s13304-021-01025-3

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