An experience of total laparoscopic partial colectomy with intracorporeal triangulating anastomosis in an obese patient with descending colon cancer

• Published in: Asian journal of endoscopic surgery Vol. 15; no. 2; pp. 393 - 396
• Main Authors: Okita, Atsushi, Tsukuda, Kazunori, Yamamoto, Sumiharu, Ikeya, Nanami, Yokoyama, Nobuji
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.04.2022; Wiley Subscription Services, Inc
• Subjects: Aged; Anastomosis, Surgical - methods; Colectomy - methods; Colon - surgery; colon cancer; Colon, Descending - surgery; Colorectal cancer; Endoscopy; Female; Humans; intracorporeal anastomosis; laparoscopic surgery; Laparoscopy; Laparoscopy - methods; Neoplasms - surgery; Obesity - complications; Obesity - surgery; intracorporeal anastomosis; colon cancer; laparoscopic surgery
• ISSN: 1758-5902; 1758-5910
• DOI: 10.1111/ases.13016

A 68‐year‐old woman was transferred to the emergency room of Okayama City Hospital because of worsening epigastric pain. After the examination, she was diagnosed with descending colon cancer, and laparoscopic colectomy was planned. However, exteriorization of the bowels to produce anastomosis was difficult because the rich adipose tissue of the mesocolon hardly stretched, and the abdominal wall was thick as the patient was obese. Therefore, an intracorporeal triangulating end‐to‐end anastomosis was performed. The colon was divided at 10 cm either side from the tumor using an endoscopic linear stapler. After the resection of the stumps with staples, the posterior walls were tied with stay sutures and then stapled with an endoscopic linear stapler. The anterior wall was stapled twice in the same manner, and the intracorporeal anastomosis was completed. The patient's postoperative course was uneventful. This technique provided an alternative intracorporeal anastomotic technique as troubleshooting in laparoscopic colectomy.