How safe are laparoscopic intracorporeal anastomoses?

BACKGROUND

A recent German Multicenter Study comprising 3 070 laparoscopic colorectal resections indicates that complete intracorporeal anastomoses are performed in only 1.8 % cases. The aim of our study was to review and analyse the safety of complete intracorpeal anastomosis.

METHODS

In a literature survey we searched for complete intracorporeal anastomosis with different key words.

RESULTS

In agreement with the literature, technically demanding hand-sutured anastomoses are no common practice. Intracorporeal anastomosis is usually done using endoscopic linear stapling devices or a conventional circular stapler by performing end-to-end, end-to-side, and side-to-side anastomoses. These techniques are more frequently used in the upper than in the lower gastrointestinal tract.

CONCLUSIONS

The data published so far, however, indicates that completely intracorporeal performed anastomoses are safe in the hands of laparoscopically experienced surgeons. This technique implies very low percentages of postoperative stenoses (0-10 %) and, furthermore, very low percentages of postoperative anastomotic leakages (0-8 %).