Rectal Transection by the Nelaton Catheter Pulling Method During a Laparoscopic Low Anterior Resection
- 1 April 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Diseases of the Colon & Rectum
- Vol. 54 (4), 495-500
- https://doi.org/10.1007/dcr.0b013e318207026f
Abstract
A laparoscopic low anterior resection with double-stapling technique for lower rectal cancer is considered to be technically challenging because it is difficult to perform rectal transection and anastomosis in the narrow pelvic cavity. We developed a new method for transecting the rectum with stapling a small number of cartridges. In laparoscopic low anterior resection, a 70-mm endovascular clip clamps the rectal wall at the anal side of the tumor. An endolinear stapler is applied at the rectal wall parallel and caudal to the 70-mm endovascular clip. A Nelaton catheter of 3.5 to 4.5 mm in outer diameter is inserted, and the loop of the Nelaton catheter is made behind the rectum. The Nelaton catheter loop is applied at the rectal wall parallel and caudal to the endolinear stapler and is pulled parallel the endolinear stapler toward the anterior side of the rectum. The endolinear stapler with opened jaws can be pushed deeper into the space, then the jaws can be closed in a position that can transect the rectum with one firing using only one cartridge. Curative low anterior resection with rectal transection using the Nelaton catheter pulling method was performed in 13 patients with rectal cancer. The median value and range of tumor distance from the anal verge were 6.0 and 4.5 to 10.0 cm. The median duration of the operation was 284 minutes, and median blood loss was 10 mL. The number of stapling cartridges used for rectal transection was 1 in all cases, and there were no major complications. We have demonstrated a safe, easy, and effective new transection method for rectal cancer resection using one firing with a Nelaton catheter.Keywords
This publication has 11 references indexed in Scilit:
- Laparoscopic-assisted anterior resection with double-stapling technique anastomosis: safe and feasible for lower rectal cancer?Surgical Endoscopy, 2008
- Results of a multicenter study of 1,057 cases of rectal cancer treated by laparoscopic surgerySurgical Endoscopy, 2008
- Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resectionInternational Journal of Colorectal Disease, 2008
- New Laparoscopic Double-Stapling TechniqueDiseases of the Colon & Rectum, 2007
- Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trialThe Lancet Oncology, 2005
- Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trialThe Lancet, 2005
- A Comparison of Laparoscopically Assisted and Open Colectomy for Colon CancerNew England Journal of Medicine, 2004
- Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomesSurgical Endoscopy, 2004
- A novel laparoscopic technique for stapled colon and rectal anastomosisTechniques in Coloproctology, 2003
- Effect of the introduction of total mesorectal excision for the treatment of rectal cancerBritish Journal of Surgery, 1998