Anastomosis technique, gastrointestinal, with circular stapler

  1. Resecting the rectum

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    Resecting the rectum
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    The technique is illustrated with descendorectostomy serving as an example (see also open rectal resection). The rectum is transected with a linear stapler.

  2. Dissecting the wall of the descending colon

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    Free the section of intestine to be anastomosed from the attached tissue over a distance of 5-10 mm.

  3. Arming the proximal stump with a purse-string suture

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    First, clean and disinfect the proximal stump of the large bowel with a swab (e.g., soaked in povidone-iodine) (not illustrated). Then preplace an over-and-over purse-string suture of strong monofilament material with stitches every 4 mm Finally, insert the anvil and tie the purse string suture on the anvil shaft.

    Note: The purse-string suture may also be fashioned with a purse-string clamp and a double-ended suture with straight needles.

  4. Inserting the stapler transanal

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    Insert the stapler transanally and pierce the staple line with the trocar of the staple housing.

    Note: In the video, the trocar has already been removed.

Connecting anvil and staple housing

Slide the anvil shaft over the trocar until the anvil snaps into fully seated position. ... - Opera

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