Rectal Transection by Pushing Method Using the Rectum Holding Forceps During Laparoscopic Anterior Resection

Abstract

Introduction

Anastomosis leakage is a serious complication in patients with rectal cancer. Reducing anastomosis leakage in the double-stapling technique is always challenging. Recently, we developed a novel laparoscopic surgical technique and device for use during rectum transection.

Surgical Technique

In anterior resection, the rectum is sutured and cut using a linear stapler. An operator inserts a stapler through a port in the lower right abdomen, and an assistant inserts the rectum holding forceps through a port in the lower left abdomen. A silicone rubber band positioned at the tip of the rectum holding forceps (Hariki Seiko Co. Ltd) is hooked to the tip of the stapler, with force applied from the elastic band extending from the tip toward the handle on both the oral and anal sides of the stapler, preventing the elastic band from sliding out toward the tip of the stapler. The rectum is pushed into the stapler to the appropriate position and then clamped, sutured, and cut. Ten patients prospectively underwent rectal transection using the rectum holding forceps during rectal transection. Performing this technique was possible in all cases using a single linear stapler.

Conclusion

Using this technique and device, the rectum could be cut in the appropriate position using a reduced number of staples.