Rectal transection by the Nelaton catheter pulling method during a laparoscopic low anterior resection

Area of Science:

• Colorectal surgery
• Surgical oncology
• Minimally invasive procedures

Background:

• Laparoscopic low anterior resection (LAR) for lower rectal cancer presents technical challenges due to narrow pelvic anatomy.
• Rectal transection and anastomosis are particularly difficult in confined spaces.

Purpose of the Study:

• To present a novel, simplified technique for rectal transection during laparoscopic LAR.
• To address the technical difficulties of rectal transection in narrow pelvic cavities.

Main Methods:

• A new method involving a 70-mm endovascular clip, endolinear stapler, and a Nelaton catheter was developed.
• The Nelaton catheter loop is used to facilitate deeper stapler placement for rectal transection.
• This technique aims to achieve rectal transection with a single stapler firing.

Main Results:

• The Nelaton catheter pulling method was successfully applied in 13 patients undergoing curative LAR for rectal cancer.
• Rectal transection was consistently achieved using only one stapling cartridge.
• The procedure demonstrated minimal blood loss (median 10 mL) and no major complications.

Conclusions:

• A safe, easy, and effective new method for rectal transection in rectal cancer resection has been demonstrated.
• The Nelaton catheter technique simplifies stapling in laparoscopic LAR.
• This approach offers a viable solution for challenging rectal dissections.