Presentation Information
[E1-5]Single stapler anastomosis in minimal invasive rectal surgery-outcome in single institution
Chu Cheng Chang1, Ming Yin Shen1,2, Tzu Liang Chen1,2 (1.Department of Surgery, China Medical University HsinChu Hospital, 2.China Medical University)
Background Anastomotic leakage in rectal surgery can lead to increased morbidity, mortality, and a higher rate of local tumor recurrence. Many risk factors, such as blood supply, tension, and patient comorbidities, have been identified as contributing to the risk of leakage. Several studies have noted that the numbers of staplers used during rectal transection is an independent risk factor for anastomotic leakage. Here, we present our experience with single stapler anastomosis in minimal invasive rectal surgery.
Method After completing the dissection of rectum, the transection point was selected. One purse-string suture was made proximal to transection point to close the rectum. The transection was done with scissors. We made another hand-sewn purse-string suture at rectum stump in laparoscopic or robotic platform. The anastomosis was completed with single staple circular stapler.
Result From November 2022 to April 2025, we’ve performed 28 single stapler anastomosis. 18(64.3%) male and 10(35.7%) female patients. The mean age was 59.3(38-80) years old. 4 patients had received pre-operative radiotherapy. 3(10.7%) patients received laparoscopic surgery and 25(89.3%) had robotic surgery. 7(25%) patients received natural orifice specimen extraction surgery. 3 patients had protective stoma diversion. The mean anastomosis height was 5.25(2-8) cm from anal verge. There were 4(14.3%) patients experienced post-operative complications. One post-operative ileus, one acute urinary retention, one intraabdominal infection, and one patient had anastomosis leakage. The overall leakage rate was 3.6%. The mean length of stay was 6(3-20) days.
Conclusion Our result showed single stapler anastomosis in rectal surgery is a feasible and promising method in minimal invasive surgery.
Method After completing the dissection of rectum, the transection point was selected. One purse-string suture was made proximal to transection point to close the rectum. The transection was done with scissors. We made another hand-sewn purse-string suture at rectum stump in laparoscopic or robotic platform. The anastomosis was completed with single staple circular stapler.
Result From November 2022 to April 2025, we’ve performed 28 single stapler anastomosis. 18(64.3%) male and 10(35.7%) female patients. The mean age was 59.3(38-80) years old. 4 patients had received pre-operative radiotherapy. 3(10.7%) patients received laparoscopic surgery and 25(89.3%) had robotic surgery. 7(25%) patients received natural orifice specimen extraction surgery. 3 patients had protective stoma diversion. The mean anastomosis height was 5.25(2-8) cm from anal verge. There were 4(14.3%) patients experienced post-operative complications. One post-operative ileus, one acute urinary retention, one intraabdominal infection, and one patient had anastomosis leakage. The overall leakage rate was 3.6%. The mean length of stay was 6(3-20) days.
Conclusion Our result showed single stapler anastomosis in rectal surgery is a feasible and promising method in minimal invasive surgery.