Modified Delta-shaped Anastomosis via the Overlap Method Using Linear Staplers for Colon Cancer

Pramod Nepal; Shinichiro Mori; Yoshiaki Kita; Kan Tanabe; Kenji Baba; Ken Sasaki; Hiroshi Kurahara; Takaaki Arigami; Kosei Maemura; Takao Ohtsuka; Shoji Natsugoe

doi:10.23922/jarc.2020-013

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Modified Delta-shaped Anastomosis via the Overlap Method Using Linear Staplers for Colon Cancer

Pramod Nepal, Shinichiro Mori, Yoshiaki Kita, Kan Tanabe, Kenji Baba, Ken Sasaki, Hiroshi Kurahara, Takaaki Arigami, Kosei Maemura, Takao Ohtsuka, Shoji Natsugoe

Author information

Pramod Nepal
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Shinichiro Mori
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Yoshiaki Kita
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Kan Tanabe
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Kenji Baba
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Ken Sasaki
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Hiroshi Kurahara
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Takaaki Arigami
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Kosei Maemura
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Takao Ohtsuka
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University
Shoji Natsugoe
Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University

Keywords: intracorporeal anastomosis, linear stapler, modified delta-shaped anastomosis via overlap method

JOURNAL OPEN ACCESS
Supplementary material

2021 Volume 5 Issue 1 Pages 107-111

DOI https://doi.org/10.23922/jarc.2020-013

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Abstract

Here, we describe the modified delta-shaped anastomosis (DSA) via the overlap method and how it was a beneficial intracorporeal anastomotic technique for four patients who underwent laparoscopic colectomy. After resecting the colon on both sides of the lesion, proximal and distal colon were laid in an overlap fashion and fixed using sutures. The entry hole was created using an ultrasound scalpel at a point 3 cm proximal to right colic stump and 7 cm distal to left colic stump on the anti-mesenteric side. Then, two arms of the linear stapler were inserted inside each lumen and fired. Finally, using the linear stapler, the common entry hole was closed in a delta-shaped manner. The mean duration of surgery was determined to be 218.4 (196-369) minutes, and amount of blood loss was measured to be 11 (5-25) mL. No intraoperative and postoperative complications were observed. Median postoperative hospital stay was 12 days. Thus, modified DSA via overlap method can be considered as a safe and simple IA technique.

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