Intracorporeal anastomoses in emergency laparoscopic colorectal surgery from a series of 59 cases: where and how to do it – a technical note and video

Abstract

This case series illustrates all possible sites and techniques for colonic ICA in an emergency setting. All colorectal and acute care surgeons should have laparoscopic suturing skills.

Laparoscopic management of acute, severe colon ischaemia: demanding emergency extended left hemicolectomy with completely intracorporeal anastomosis – a video vignette

“…In addition, we believe laparoscopy to be both a diagnostic and therapeutic procedure. Di Saverio and colleagues achieved good outcomes with primary anastomosis after both left and right emergency laparoscopic colon resections in different acute care settings . We found primary anastomosis to be feasible even in the case of severe colonic ischaemia.…”

Laparoscopic extended right and transverse colectomy with completely intracorporeal ileo‐descending anastomosis for obstructing colon carcinoma – a video vignette

“…Therefore a primary anastomosis was decided and a completely intracorporeal side-to-side stapled anisoperistaltic anastomosis between the distal ileum and descending colon was fashioned. Hand-sewn double layer closure of the enterotomy was performed, according to the technique previously described for intracorporeal anastomoses in emergency colorectal surgery [1]. Histology revealed completely excised G2 stenosing adenocarcinoma of the transverse colon (pT3N0; 0/18 lymph nodes).…”

“…For repair of bilateral inguinal hernia, Stoppa reported a recurrence rate of 1.4% using a preperitoneal approach [1,2]. The endoscopic technique for bilateral inguinal hernia is attractive because it is known to result in less postoperative pain and to ensure more rapid recovery than conventional hernia repair [3,4].…”

A novel technique for enterotomy closure in stapled laparoscopic intracorporeal anastomosis

“…This technique has been used in 10 cases to date (April 2017) by the consultant surgeon (SdS); the details are shown in Table . Four cases were elective and six cases were performed in an acute care setting and the technique proved to be safe and effective in the closure of the enterotomy with no leaks or fistulas occurring from this site of the anastomosis angle. Our preliminary results suggest that such technique may allow a technically easier closure of the apex of the enterotomy and may be useful in avoiding mistakes and incomplete closure and leaving an open orifice within the proximal angle of the enterotomy, thereby reducing the risk of anastomotic leakage after a stapled ICA.…”