Dr Pascal Gervaz

Chirurgien FMH, chirurgie interne & chirurgie viscérale



Totally Intracorporeal Laparoscopic Colorectal Anastomosis Using Circular Stapler




by Pascal Bucher, Philippe Wutrich, Francois Pugin, Michel Gonzales, Pascal Gervaz, Philippe Morel





A number of surgical techniques for colorectal anastomosis have been described for laparoscopic left-sided colectomies. Due to the complexity of these procedures, open preparation of the proximal bowel for circular stapler anastomosis through a Pfannenstiel incision has become the gold standard. We report a new laparoscopic technique for totally intracorporeal colorectal circular anastomosis (TLCCA) using a circular stapler.



Preliminary experience using TLCCA in three patients scheduled for laparoscopic left colectomies (two) and sigmoidectomy (one).



Side-to-end colorectal anastomosis through TLCCA was feasible in all patients scheduled for preliminary experience. Median time from anvil insertion into abdominal cavity to anastomosis was 14 (11–17) minutes. No postoperative complications were recorded.



Side-to-end anastomosis can be easily and safely performed using conventional circular stapler through TLCCA. TLCCA is performed using four laparoscopic ports without additional skin incision (except trocars incision) and allows the retrieval of surgical pieces through a specimen bag.


in Surgical Endoscopy, May 2008, Volume 22, Issue 5, pp 1278-1282