[Use of surgical staplers in the lower gastrointestinal tract]

Practicability and indication for continuity preserving surgery increase by the use of staplers in the lower gastrointestinal tract. The mean rate of complications for the deep colorectal and colo-anal anastomosis decreased. Locoregional relapses occur as often as with other techniques, when the criteria of radicality have been observed. Stenoses are prevalently due to complications of extraperitoneal anastomoses. In higher large bowel sections, only a few surgeons favor the use of staplers, as the risk for the patient increases without offering particular advantages. The double stapling technique in deep anterior resection is possible for small tumors and a large pelvis. For colonic pouches linear staplers are completed by circular staplers for the subsequent pouchanal anastomosis. Studies are running, actually, regarding indication of the colonic pouch.