Laparoscopy-assisted endoscopic bowel anastomosis stenosis revision with stapler: report of two cases

Anastomosis stenosis is a complication after bowel surgery. We performed laparoscopy-assisted endoscopic revision of bowel anastomosis stenosis with a stapler in two cases: first, for secondary anastomosis stenosis 14 months after sigmoid colon resection, and second, for inadequate-size primary anastomosis after segmental colon resection requiring immediate revision. A stapler, an endoscopic linear cutter Endopath ETS (Ethicon Endo-Surgery, Cincinnati, Ohio, U.S.A.), is transanally inserted and fired once into the stricture to enlarge the inner lumen. The procedure seems to be fast and safe, less invasive, and cost-effective. This new technique can be used to avoid open surgery in cases of postoperative anastomosis stenosis as well as initially to increase the anastomosis diameter of the lower colon.