Modified Delta-shaped Anastomosis via the Overlap Method Using Linear Staplers for Colon Cancer

Abstract

Here, we describe the modified delta-shaped anastomosis (DSA) via the overlap method and how it was a beneficial intracorporeal anastomotic technique for four patients who underwent laparoscopic colectomy. After resecting the colon on both sides of the lesion, proximal and distal colon were laid in an overlap fashion and fixed using sutures. The entry hole was created using an ultrasound scalpel at a point 3 cm proximal to right colic stump and 7 cm distal to left colic stump on the anti-mesenteric side. Then, two arms of the linear stapler were inserted inside each lumen and fired. Finally, using the linear stapler, the common entry hole was closed in a delta-shaped manner. The mean duration of surgery was determined to be 218.4 (196-369) minutes, and amount of blood loss was measured to be 11 (5-25) mL. No intraoperative and postoperative complications were observed. Median postoperative hospital stay was 12 days. Thus, modified DSA via overlap method can be considered as a safe and simple IA technique.

A new overlapped delta‐shaped anastomosis technique using linear staplers with reinforced bioabsorbable material for intracorporeal anastomosis during laparoscopic colectomy

“…However, it needs three stay sutures to close the common enterotomy using a linear stapler which may increase the risk of distal stenosis, as described earlier. Similarly, we have previously described the safety and efficacy of a modified delta‐shaped anastomosis with an overlap method, where we used one supporting suture to fix the colonic ends and three stay sutures to elevate bowel ends before common enterotomy closure [5]. In the present study, we discuss a construction technique for overlapped delta‐shaped anastomosis using a linear stapler with a reinforced bioabsorbable material.…”

A sutureless overlapped anastomosis technique using linear staplers with reinforced bioabsorbable material in robotic right colectomy with intracorporeal anastomosis

“…Laparoscopic surgery is the preferred approach to colectomy because of its lower mortality rate, reduced complication rate, earlier recovery of bowel function, lower ostomy rate, shorter median length of stay, higher routine discharge rate, lower overall cost compared with open colectomy, and similar long-term oncological outcomes [1][2][3]. Another advantage of laparoscopic surgery for colectomy is the ability to perform an intracorporeal anastomosis (IA) [4,5]. A meta-analysis of five randomized controlled trials comparing IA with extracorporeal anastomosis (EA) in laparoscopic right colectomy (LRC) revealed significantly better outcomes in the IA group.…”