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

• Main Authors: Pramod Nepal, Shinichiro Mori, Yoshiaki Kita, Kan Tanabe, Kenji Baba, Ken Sasaki, Hiroshi Kurahara, Takaaki Arigami, Kosei Maemura, Takao Ohtsuka, Shoji Natsugoe
• Format: Article
• Language: English
• Published: The Japan Society of Coloproctology 2021-01-01
• Series: Journal of the Anus, Rectum and Colon
• Subjects: intracorporeal anastomosis; linear stapler; modified delta-shaped anastomosis via overlap method
• Online Access: https://www.jstage.jst.go.jp/article/jarc/5/1/5_2020-013/_pdf/-char/en

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.