New way of laparoscopic intracorporeal term-terminal invagination ileotransverse anastomosis

Abstract

Background. Laparoscopic surgery becomes a standard treatment for many surgical diseases. Defects of a stapler laparoscopic mechanical suture during the formation of an anastomosis after hemicolectomy are detected in 18% of observed cases.Objective. Development, substantiate reproducibility and safety of a manual intracorporeal term-terminal invagination ileotransverse anastomosis method after performing the right laparoscopic hemicolectomy.Material and Methods. Authors presented a description of the technique and their own experience of performing laparoscopic hemicolectomy on the right with the formation of a manual original anastomosis in 10 patients with pathology of the right half of the colon. Eight patients (80.0%) had a malignant tumor of the right half of the colon, 1 patient (10.0%) showed multiple polyps of the cecum and the ascending part of the colon, 1 patient (10.0%) developed a cystic-solid submucosa tumor of the ileocecal angle. One patient had metastatic lung disease at the time of establishing diagnosis. The postoperative follow-up period was 7–18 months.Results. There were no conversions to open surgery. All operations (n = 10) were ended completely laparoscopically – right hemicolectomy with standard D2 lymph node dissection. In one patient, we revealed intraoperatively the spread of the tumor to the gallbladder, which required additional cholecystectomy. The duration of the operation was 122.5 ± 10.7 min.; median blood loss was 107 ± 5.2 ml. At the time of follow-up all patients are alive.Conclusion. The technique is universal in the surgical treatment of patients with various pathologies of the right half of the colon.

Keywords

• colorectal cancer
• laparoscopy
• hemicolectomy
• intracorporeal anastomosis