When staplers misfire: endoscopic rescue of low pelvic anastomoses

The end-to-end stapler has made it possible for colorectal surgeons to construct deeper anastomoses. Although complications associated with the device are mainly postoperative, very serious intraoperative complications, such as stapler misfire, can occur. The authors report their experience with two cases of stapler misfire, describing their method for the extraction of the device and the entrapped tissue using a flexible sigmoidoscope and a hot biopsy forceps. There were no immediate or long-term problems. The technique appears to be safe and effective.