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Video

Session: Ongoing Videos

VM14 - Seamless Connection: Innovative Technique for colocolonic end-to-end stapled anastomosis

ONGOING VIDEOS
Location: ASCRS Connect Lounge, Hall B1/B2, Ground Level

    Video Presentation(s)

  • Carlos Fairen Oro, Resident (he/him/his)

    Chief Surgery Resident
    Boston University Medical Center
    Boston University
    Boston, MA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Sara Myers, MD

    Resident
    Boston University/Boston Medical Center
    Boston, MA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Jennifer Davids, MD, FACS, FASCRS (she/her/hers)

    Chief of Colon and Rectal Surgery
    Boston Medical Center/Boston University School of Medicinie
    Boston University
    Boston, Massachusetts, United States

    All of the relevant financial relationships listed below have been mitigated.
    Axonics: Honoraria (Terminated, June 1, 2023); Olympus: Consultant (Terminated, June 8, 2024); SafeHeal: Consultant (Terminated, February 1, 2024); Tavanta: Consultant (Terminated, March 31, 2024)

    • Senior Author(s)

  • OB

    Olga Beresneva, MD

    Assistant Professor of Surgery
    Boston Medical Center/Boston University School of Medicine
    Boston, MA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • SR

    Samantha Rivard, MD

    Colorectal Surgeon
    Boston Medical Center
    North Reading, Massachusetts, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Carlos Fairen Oro, Resident: This individual has no financial relationships with ineligible companies.
Sara Myers, MD: This individual has no financial relationships with ineligible companies.
Jennifer Davids, MD, FACS, FASCRS: Axonics: Honoraria (Terminated, June 1, 2023); Olympus: Consultant (Terminated, June 8, 2024); SafeHeal: Consultant (Terminated, February 1, 2024); Tavanta: Consultant (Terminated, March 31, 2024)
Olga Beresneva, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Patients with obstructive colon cancer present a technical challenge when attempting to perform primary anastomosis given size discrepancy between the proximal dilated colon and the distal decompressed colon. Often, these patients have a higher risk of ostomy creation and higher risk of anastomotic leak if primary anastomosis is performed. Depending on anatomic location, surgeons often perform side-to-side, end-to-side or end-to-end anastomosis using linear or circular staplers as well as hand sewn anastomosis. Some studies have reported different rates of complications among different techniques but this still remains a matter of discussion.

Methods/Interventions: A 69-year-old male presented to the emergency room with 3 days of abdominal pain, distension and obstipation. CT scan found an obstructing splenic flexure mass. A colonoscopy was performed with biopsy of the mass and stent placement for decompression. After improvement of symptoms, patient was taken to the operating room 7 days after stent placement for a laparoscopic oncologic segmental colectomy of the splenic flexure colon with end-to-side circular anastomosis using EEA stapler. Final pathology revealed a T3N0 invasive adenocarcinoma with adequate oncologic resection and 30 negative lymph nodes.

Results/Outcomes: There were no intraoperative complications. He was discharged on postoperative day 2 after return of bowel function

Conclusion/Discussion: Creation of an end-to-end stapled circular anastomosis is a valid option for patients with significant size discrepancy of the proximal and distal colon, such as with an obstructing colon cancer. End-to-end anastomosis can recreate the splenic flexure and allow for an easier surveillance colonoscopy from a technical perspective compared to a side-to-side functional end-to-end anastomosis. End-to-end circular anastomosis can prevent functional issues associated with side-to-side colonic anastomosis