Abstract
We have experienced totally laparoscopic colectomy with laparoscopic functional end-to-end anastomosis and extraction of the resected colon via the anus in a series of 19 cases of colon cancer. Indications for this technique were the tumors which had not serosal invasion nor did lymph node metastasis and were thought to be eligible for transanal extraction. After regional lymph node dissection, both oral and anal sides of the specimen were cut with linear stapler, and the anal side of the colon was washed with a colonoscope equipped with a water jet. After removing the stapler of the anal side colon, the resected specimen was extracted via the open distal end of the colon and anus, with the aid of colonoscopy. After the distal colon was closed by auto-suturing, functional end-to-end anastomosis was performed. In our series including 19 patients, transanal extraction of the resected colon with intracorporeal anastomosis resulted in no serious complications such as suture failure. This technique did not demand small laparotomy, so that the wound scar was limited to the trocar site and postoperative pain was slight. This technique which can provide cosmetic advantage and minimal invasiveness is reported here together with our experience.
