1 Jan 2019Article
Laparoscopic modified double stapling technique with transanal resection for low anterior resection of rectal cancer
Giulio Illuminati 1Dimitri Krizzuk 1Giulia Pizzardi 1Bruno Perotti 1Rocco Pasqua 1Paolo Urciuoli 1
Affiliations
Article Info
1 The Department of Surgical Sciences, “La Sapienza” University of Rome, Rome, Italy
Ann. Ital. Chir., 2019, 90(1), 78-82;
Published: 1 Jan 2019
Copyright © 2019 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
BACKGROUND AND AIM: Anterior resection of the rectum with a total mesorectal excision is the standard surgical technique for the treatment of rectal cancer. Laparoscopic low anterior resection (LALAR) is an alternative to open surgical approach and was validated in diverse randomized control trials to be as safe and oncologically effective. That said, confronting a low rectal tumor in an obese patient with a narrow pelvis can be technically challenging even for the most expert surgeon. METHODS: We propose a modified double stapling technique with transanal eversion and staple resection of the rectal stump. RESULTS: We applied the above technique in 3 patients with a dubious distal resection margin due to patient/tumor characteristics. The mean length of operation was 272 minutes and a R0 resection with a mean number of 16 nodes could be obtained in all the patients. No recurrence occurred during a follow-up of 28 months. CONCLUSIONS: We conclude that this technique is a feasible, safe and valid adjunct to the double staple technique whenever intraabdominal application of the linear staple is difficult or unsafe.
Keywords
- Colorectal cancer
- Laparoscopic anterior resection
- Double
- Low colorectal anastomosis
- Stapling technique