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Techniques for Laparoscopic Distal Rectal Stapled Transection

  • Howard M. RossEmail author
Chapter

Abstract

Distal rectal stapled transection can be challenging due to the narrow bony confines of the pelvis, adipose stores, and the technical limitations of staplers. Techniques to facilitate distal rectal stapled transection are discussed including fully mobilizing the rectum, utilizing upward pressure on the perineum, maximizing the abilities of current roticulating staplers, or placement of a nonroticulating stapler through a Pfannenstiel incision. Possession of a large armamentarium of tips and tricks as well as an understanding of what factors are associated with successful distal anastomosis will serve the surgeon performing rectal surgery well.

Keywords

Distal rectal transection Surgical stapling Low anterior resection Surgical technique 

Suggested Reading

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    Ito M, et al. Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection. Int J Color Dis. 2008;23(7):703–7.CrossRefGoogle Scholar
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    Kim IS, et al. Risk factors for anastomotic leakage after laparoscopic intracorporeal colorectal anastomosis with a double stapling technique. J Am Coll Surg. 2009;209:694–701.CrossRefGoogle Scholar
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    Lee S, et al. The relationship between the number of intersections of staple lines and anastomotic leakage after the use of a double stapling technique in laparoscopic colorectal surgery. Surg Laparosc Endosc Percutan Tech. 2017;27(4):273–81.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Colon and Rectal SurgeryLewis Katz School of Medicine at Temple University and the Temple University Health SystemPhiladelphiaUSA

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