Technique: We propose a small improvement termed "U-tied functional end-to-end anastomosis", aiming to promote the standardization of totally laparoscopic colectomy. After bowel mobilization and vascular ligation, the proximal and distal bowel regions are tied in parallel using a ligature. Anastomosis is completed using a linear stapler through the common enterotomies. Resection of the bowel and closure of the stump are then performed simultaneously with one cartridge following the bowel anastomosis.
Results: Thirty patients underwent U-tied anastomosis from December 2019 to October 2022. In all cases, two cartridges were used to complete the U-tied procedure. There were no major complications or mortality within 30 days after the operation, and only one patient developed mild surgical site infection.
Conclusions: The U-tied intracorporeal anastomosis is safe and effective, simplifying the reconstruction process and reducing the discrepancy between the operators' experience on the anastomotic outcomes. Thus, this procedure may promote homogeneity of intracorporeal anastomosis and reduce the use of cartridges.
Keywords: Colon cancer; Intracorporeal anastomosis; Total laparoscopy.
Copyright © 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Published by Elsevier B.V. All rights reserved.