Double-stapled intracorporeal anastomosis for minimally invasive right and left colectomies: a standardized technical approach.

BACKGROUND

Minimally invasive surgery (MIS) for colorectal procedures has become increasingly common, with intracorporeal anastomosis (ICA) gaining traction due to its documented patient benefits. However, widespread adoption and teaching of ICA can be challenging, often due to the reliance on advanced intracorporeal suturing skills. This technical note describes a standardized, fully stapled intracorporeal side-to-side anastomosis technique for minimally invasive right and left colectomies, aiming to simplify its execution and improve reproducibility.

TECHNIQUE: The procedure begins with deliberate port placement and patient positioning tailored for robotic access. Following full bowel mobilization and mesenteric division, anti-mesenteric stay sutures are placed to facilitate optimal alignment. Enterotomies are carefully created, and a double-stapled intracorporeal anastomosis is performed using sequentially oriented 60-mm enteric stapler loads. The technique emphasizes precise tissue handling, proper stapler orientation, and visual confirmation of perfusion.

CONCLUSION

This standardized, fully stapled approach offers a reproducible and efficient solution to performing intracorporeal side-to-side intestinal anastomosis. By eliminating the need for intracorporeal hand-sewn closure and leveraging familiar stapler-based principles, this technique aims to lower the technical barrier to adoption and facilitate its teaching across both robotic and laparoscopic platforms. Future studies are warranted to investigate the learning curve and clinical outcomes of this standardized technique.