Technical considerations for an extracorporeal anastomosis after a right colectomy
Posted in Videos on 10 February 2015
Published by Gabriel Díaz
Salvadora Delgado (Gastrointestinal Surgery Senior Consultant)
María Fernández-Hevia (Gastrointestinal Surgery Specialist)
Hospital Clínic, Barcelona – Spain
There are many ways to perform an extracorporeal anastomosis
after a right colectomy. This video reflects one of them.After the oncological dissection the specimen is exteriorized through a small incision, the wound is protected
during this maneuver.
The proximal and distal margins are selected. Then, the mesocolon is sectioned with the ligasure to prepare the colon. Mechanical staplers were used for section, one knot is placed at the stapler line of the colon and small bowel for traction during the firing.
A enterotomy and a colotomy were performed to introduce the stapler, it is important to supervise a symmetrical involvement and to avoid twisting. A knot is placed at the end of the stapler line to release tension. The endoluminal part is revised for bleeding.
One last knot is placed at the junction of the stapler lines to improve symmetrical traction, a last firing is done and a verification of a correct anastomotic lumen is made.