Three-Stapler Uncut Overlap Anastomosis in Laparoscopic Right Colectomy: Short-Term Outcomes and Technical Feasibility.

BACKGROUND

Intracorporeal anastomosis in laparoscopic right colectomy offers several clinical advantages but is often associated with higher costs due to the increased number of stapler firings compared to extracorporeal anastomosis. We developed a novel "three-stapler uncut overlap anastomosis" to reduce costs while maintaining the benefits of intracorporeal anastomosis.

METHODS

We retrospectively reviewed 60 patients who underwent minimally invasive right colectomy using this technique between February 2023 and November 2025. The procedures included robot-assisted (n = 31), conventional laparoscopic (n = 20), and single-incision laparoscopic surgeries (n = 9). The technique involves initially dividing only the colon, maintaining an intact ileum during anastomosis, and completing ileal transection simultaneously with enterotomy closure.

RESULTS

The technique was successfully completed with only three stapler firings in 58 patients (96.7%). The median operative time was 231 min, and the median open bowel time was 11 min. No cases of anastomotic leakage, stenosis, or major perioperative complications (Clavien-Dindo Grade ≥ IIIb) were observed. Pathological examination confirmed R0 resection with adequate margins in all cases.

CONCLUSIONS

The three-stapler uncut overlap anastomosis appears to be a safe, feasible, and cost-effective reconstruction method for minimally invasive right colectomy. It provides excellent short-term outcomes while minimizing the economic burden associated with intracorporeal anastomosis.