A novel technique for enterotomy closure in stapled laparoscopic intracorporeal anastomosis

Abstract

This 'back-handed, left-to-right' stitch described here allows a properly angled closure of the proximal edge of the enterotomy and a safe approximation of the corner of the enterotomy in a side-to-side ICA.

‘Back‐handed, left‐to‐right’ intracorporeal anastomosis technique during laparoscopic right hemicolectomy: a safe and reproducible approach

“…We read with great interest the paper written by di Saverio et al . entitled ‘A novel technique for enterotomy closure in stapled laparoscopic intracorporeal anastomosis’, published in Colorectal Disease , 2017. The authors presented a new technique for the closure of the enterotomy in stapled laparoscopic intracorporeal anastomosis (IA) during laparoscopic right hemicolectomy .…”

“… entitled ‘A novel technique for enterotomy closure in stapled laparoscopic intracorporeal anastomosis’, published in Colorectal Disease , 2017. The authors presented a new technique for the closure of the enterotomy in stapled laparoscopic intracorporeal anastomosis (IA) during laparoscopic right hemicolectomy . Unlike conventional ‘right‐handed, right‐to‐left’ technique for suturing the proximal edge of the enterotomy, the new technique proposed by di Saverio et al .…”

“…Unlike conventional ‘right‐handed, right‐to‐left’ technique for suturing the proximal edge of the enterotomy, the new technique proposed by di Saverio et al . provided closing the proximal edge of the enterotomy with the ‘back‐handed, left‐to‐right’ method. This approach would allow a properly angled closure of the proximal/lower extremity of the enterotomy and a symmetrical approximation of the edges in the corner of the IA .…”

“… provided closing the proximal edge of the enterotomy with the ‘back‐handed, left‐to‐right’ method. This approach would allow a properly angled closure of the proximal/lower extremity of the enterotomy and a symmetrical approximation of the edges in the corner of the IA . Thus, it would allow optimal closure of deepest extremity of the enterotomy, reducing the risk of anastomotic leakage after a stapled IA .…”

“…There are two techniques reported for the ileocolic anastomosis: IA and extracorporeal anastomosis (EA) . Most laparoscopic side‐to‐side ileocolic anastomoses are performed extracorporeally, due to technical difficulties . Three recent meta‐analyses showed that IA gave greater advantages than EA .…”