'Above and below' dilatation of anastomotic colorectal strictures

A new technique is described for dilating anastomotic colorectal strictures lying distal to a protecting stoma where attempts at instrumentation from below have failed. The new manoeuvre consists of approaching the stricture simultaneously from above, using a fibrescope inserted through the stoma, and from below using a rigid sigmoidoscope. A guidewire is passed from above through the stricture and retrieved by the lower operator. Dilators can then be railroaded through it. Six successful cases are reported.