Intracorporeal laparoscopic cecorectal anastomosis

We recently described a laparoscopically assisted subtotal colectomy with extracorporeal antiperistaltic cecorectal anastomosis (CRA). We modified this technique by performing an intracorporeal CRA: the anvil head assembly removed from the circular stapler with an ancillary trocar placed into the anvil shaft is pushed through the bottom of the cecum, the cecum with the anvil head assembly is brought into the pelvis, the circular stapler is inserted into the rectum and the cecoproctostomy is performed. Two patients underwent this new laparoscopic subtotal colectomy with CRA. The operating times were 230 and 260 minutes, respectively. There was no postoperative morbidity. Our results allow us to state that intracorporeally performed antiperistaltic cecoproctostomy after laparoscopic subtotal colectomy is feasible.