Modification of the stapled functional end-to-end anastomosis for ileostomy closure

The use of stapling devices simplifies ileostomy closure; however, the original functional end-to-end anastomotic technique creates intersecting staple lines, generally causing disruption of the anastomosis at the intersections. Therefore, we modified the stapling technique to prevent the two staple lines from crossing. After the everted ileostomy spout is turned back, a stapled side-to-side anastomosis is made. Everting traction sutures are then placed around the ileostomy orifice prior to closure with a linear stapler, thus ensuring that this staple line does not cross the V-shaped staple line of the intestinal anastomosis. This modified technique was employed in the treatment of 20 patients, none of whom developed any signs of anastomotic leakage or intestinal obstruction.