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New technique for rectal division in laparoscopic anterior resection--with video
Yosuke Fukunaga1, Masayuki Higashino, Shinya Tanimura
1Department of Gastroenterological Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondoori, Miyakojima-ku, Osaka 5340021, Japan. YosukeF@aol.com
Background:
A new technique for performing laparoscopic anterior resection is described. Main differences from the standard technique are (1) pneumoperitoneum to improve exposure of the rectum, even in a narrow pelvis; (2) rectal division performed using a conventional linear stapler inserted via a 4.5 cm suprapubic incision; and (3) eversion of the rectum for tumors close to the anal verge, with transection performed under direct vision.
Methods:
Results in 78 patients who underwent transabdominal transection and in 7 patients requiring rectal eversion were compared retrospectively with those in 61 consecutive patients who had undergone standard laparoscopic resection.
Results:
The duration of the operation and estimated blood loss were greater with rectal eversion, and more staple cartridges were used for the conventional technique; however, the incidence of complications was similar for all three groups. Five patients in the conventional group required conversion to an open procedure.
Conclusion:
The new technique should improve the safety of resection.
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