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Single-Incision Laparoscopic Anterior Resection Using a Curved Stapler.

Jun Watanabe1, Mitsuyoshi Ota, Yusuke Suwa

  • 11 Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan 2 Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan 3 Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

Diseases of the Colon and Rectum
|October 18, 2016
PubMed
Summary

A novel curved stapler technique enables rectal transection during single-incision laparoscopic anterior resection. This approach simplifies the procedure and may reduce the need for additional trocars, improving surgical efficiency.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • Single-incision laparoscopic colectomy presents technical challenges including instrument crowding and limited visualization.
  • Distal rectal dissection in single-incision laparoscopic anterior resection is particularly difficult with standard articulating linear staplers.

Purpose of the Study:

  • To evaluate the feasibility and safety of using a curved stapler for rectal transection in single-incision laparoscopic anterior resection.
  • To assess the potential for reducing trocar usage with this modified technique.

Main Methods:

  • A 12-mm trocar was used to insert a curved stapler extracorporeally for intracorporeal operation.
  • The technique facilitates vertical rectal dissection from the umbilicus.
  • A multichannel port was utilized after stapler insertion and reinsufflation.

Main Results:

  • Twenty-seven patients underwent the procedure without complications.
  • Rectal transection was achieved with one stapler firing in 96.3% of patients.
  • The median distal margin was 7.0 cm, and no anastomotic leakage occurred.

Conclusions:

  • Rectal transection from the umbilicus is feasible using a curved stapler in single-incision laparoscopic anterior resection.
  • This technique offers a potential to omit one trocar, streamlining the surgical approach.