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Four different intracorporeal ileocolic anastomoses during suprapubic single incision laparoscopic right hemicolectomy

G Dapri, MD, PhD, FACS, FASMBS, Hon FPALES, Hon SPCMIN, Hon BSS, Hon CBCD, Hon CBC
Epublication WebSurg.com, Apr 2015;15(04). URL: http://websurg.com/doi/vd01en4483

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  • 2015-04-14
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Background: Single incision laparoscopic right hemicolectomy is a feasible procedure. Suprapubic access allows to offer satisfactory cosmetic results in case of extended scar due to a large tumor. Intracorporeal anastomosis is mandatory through a suprapubic access, because it prevents traction on the mesentery and on the transverse mesocolon. Video: This video shows four different types of intracorporeal ileocolic anastomoses. 1) Linear mechanical side-to-side 2) Completely manual side-to-side 3) Completely manual end-to-side 4) Completely manual end-to-end At the end of each type of anastomosis, mesenteric defect closure is mandatory, to prevent intestinal obstruction caused by internal hernia. Results: After an appropriate learning curve, time to perform linear mechanical anastomosis is 25 minutes and manual anastomosis takes 40 minutes. Conclusions: Different ileocolic anastomoses can be performed and the surgeon has to choose the appropriate one, case by case. To watch the video demonstrating the entire right hemicolectomy, please click here.