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Session: Ongoing Videos

VM98 - Ileocolic Kono-S anastomosis: How I do it.

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

    Video Presentation(s)

  • Felix H. Bonilla, MD (he/him/his)

    Coloproctology fellow
    HCIC Brazil
    Panama, Panama, Panama

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

    • Senior Author(s)

  • CS

    Carlos W. Sobrado, MD, PhD

    Attending Colorectal Surgeon
    University of São Paulo
    São Paulo, Sao Paulo, Brazil

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

    • Author(s)

  • CM

    Carlos F. S. Marques, MD, PhD

    Attending Colorectal Surgeon, Director University of São Paulo Medical School , Colorectal Unit
    University of São Paulo
    São Paulo, Sao Paulo, Brazil

    Disclosure information not submitted.

  • Lucas F. Sobrado, MD, PhD (he/him/his)

    Attending Colorectal Surgeon
    University of São Paulo
    Sao Paulo, Sao Paulo, Brazil

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

  • nc

    nathalia camin, MD

    COLOPROCTOLOGY RESIDENT
    UMFSP
    sao paulo, Sao Paulo, Brazil

    Disclosure information not submitted.

  • GF

    Gabriella Fonseca, MD

    COLOPROCTOLOGY RESIDENT
    UMFSP
    sao paulo, Sao Paulo, Brazil

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Felix H. Bonilla, MD: This individual has no financial relationships with ineligible companies.
Carlos W. Sobrado, MD, PhD: This individual has no financial relationships with ineligible companies.
Lucas F. Sobrado, MD, PhD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The purpose of this video abstract is to show the feasibility of the Kono-S anastomosis and how it's performed by the colorectal team of Hospital das Clinicas, Sao Paulo; Brazil.

Methods/Interventions: The following video encases a patient with active ileocolic Crohn's disease with stenosis which had symptoms even under the influence of Adalimumab. A laparoscopic colectomy was performed, and a modified Kono-S anastomosis was indicated.
The main difference in our approach are
-The addition of hemostatic suture on top of the ligation of mesentery with advance energy devices.
-The anastomosis is created in a single layer fashioned with continuous suture in the back and front wall.

Results/Outcomes: Patient was discharged at POD4 without any complications, the follow up was satisfactory with adequate bowel movements. The team has already performed this modified technique over 10 patients with only 1 clinical leak so far, which didn't requiere reintervention.

Conclusion/Discussion: Kono-S anastomosis has shown to be a safe and feasible anastomotic technique that can be applied to the small and large intestine.
Current data suggest that this technique is effective reducing the risk of surgical recurrence of stenosis in Crohn's disease.