[Tricks, errors and dangers in use of staplers in the colorectal area]

Ten years' experience of performing 970 operations in which circular colorectal anastomoses were stapled chiefly in the lower two-thirds of the rectum according to the open standard method is reviewed. The deeper the anastomosis and the narrower the pelvis, the higher the rate of complications, especially leakages. This is not only due to pathological, anatomical reasons or technical difficulties, but also to inappropriate application and handling of the staplers. Accurate diagnosis and a systematic procedure after sufficient training can reduce this rate. A precise analysis of the mistakes and risks resulted in a number of standard techniques and tricks which perfect the use of this technology.