Intracorporeal hand-sewn technique used in totally laparoscopic colectomy

/Du Jianjun

(杜建軍，Dept Surg，Xijing Hosp Digest Dis，4th Mil Univ Xi’an 710032)…∥Chin JGastrointest Surg.-2011，14(8).-772～774

ObjectiveTo evaluate the safety and feasibility of hand-sewn anastomosis in totally laparoscopic colectomy.MethodsClinical data of 19 consecutive patients with benign(n=5)or malignant colonic diseases(n=14，4 ascending colon cancers，2 transverse colon cancers，and 8sigmoid colon cancers)treated with totally laparoscopic colectomy with a hand-sewn anastomosis were reviewed.All the procedures were performed by the same surgeon team including totally laparoscopic resection and hand-sewn anastomosis，ileocolic anastomosis after right hemicolectomy，and hand-sewn purse-string sutures in the colon.ResultsHand-sewn anastomosis was performed on 11 patients and circular-stapled anastomosis with hand-sewn purse-string sutures was performed on other 8 patients.The mean hand-sewn anastomosis time was(49.5 ±29.4)min，and the mean hand-sewn purse-string sutures time was(13.3 ±5.5)min.No patients required conversion to laparoscopy-assisted or open surgery，and there were no postoperative complications related to anastomosis.One patient with transverse colon lipoma developed mild intra-abdominal infection after surgery and recovered after conservative treatment.ConclusionTotally laparoscopic intracorporeal hand-sewn anastomosis or hand-sewn purse-string sutures for colectomy is feasible and safe when performed by experienced laparoscopic surgeons.14 refs，1 fig.1 tab.