Anastomosis technique, gastrointestinal, with circular stapler

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

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

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.

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.