Laparoscopic Right Colectomy with Intracorporeal Handsewn Anastomosis: Surgical Technique and Narrative Review of Literature

TL;DR

This paper introduces a safe and effective handsewn anastomosis technique for laparoscopic right colectomy, with no complications observed in a series of 68 cases.

Contribution

The paper presents a standardized, intracorporeal handsewn anastomosis technique for laparoscopic right colectomy, supported by institutional experience and literature review.

Findings

No anastomotic leaks or complications were observed in 68 cases using the described technique.

Intracorporeal anastomosis is associated with reduced surgical trauma and faster recovery.

Handsewn techniques may offer benefits in hemostasis and anastomotic quality in robotic-assisted surgery.

Abstract

Intracorporeal anastomosis (IA) has gained increasing acceptance in minimally invasive colorectal surgery, primarily owing to its demonstrated association with improved perioperative outcomes compared with extracorporeal techniques. Nevertheless, the specific role of intracorporeal handsewn anastomosis remains insufficiently explored within the context of laparoscopic colorectal procedures. The present study describes a standardized technique for performing a side-to-side isoperistaltic handsewn intracorporeal ileocolic anastomosis following laparoscopic right colectomy and evaluates its safety and feasibility through a review of the relevant literature and institutional experience. The procedure is executed employing a medial-to-lateral dissection approach, and a single-layer isoperistaltic handsewn anastomosis is constructed entirely intracorporeally. Over a three-year period, 68 laparoscopic right colectomies were completed using this technique, predominantly for malignant disease, all performed by a single surgeon. Notably, no anastomotic leaks or anastomosis-related complications, including bleeding, stenosis, or hematoma formation, were observed. Available evidence supports the advantages of intracorporeal anastomosis, including reduced surgical trauma, lower incidence of wound-related complications, faster recovery of bowel function, and comparable oncological outcomes. Furthermore, emerging data from robotic-assisted colorectal surgery suggest potential benefits of handsewn techniques with respect to hemostasis and anastomotic quality. In conclusion, intracorporeal handsewn ileocolic anastomosis following laparoscopic right colectomy appears to represent a safe and reproducible technique when performed by experienced surgeons, thereby warranting further prospective, comparative and multicenter studies to delineate its broader applicability and long-term outcomes.

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