COMBINED LAPAROENDOSCOPIC COLON RESECTION AND ANASTOMOSIS USING THE NO TOUCH TECHNIQUE AND FIBRIN GLUE - AN EXPERIMENTAL-STUDY

Background: Laparoscopic colon anastomosis are technically demanding. A new technique for colon resection and anastomosis using a combined l aparoendoscopic approach is presented. Methods: In 10 pigs, pneumoperi toneum was induced and 5 trocars were placed. A sigmoid segment was is olated; a vein stripper was inserted from the anus, and the head was s ecured with a tie; the segment was intussuscept ed pulling the strippe r out; 4 seromuscular sutures were placed at the anastomotic site and fibrin glue was spread all around; an electrical wire loop, introduced via a colonoscope, was used to resect the intussuscepted segment that was removed from the anus. Results: All animals but one survived unti l sacrifice at 30, 60, 90, and 120 days. Macroscopically, the anastomo sis appeared well healed; microscopically, after 90 days, there was a complete restitutio ad integrum of the intestinal wall. Conclusions: T his technique is feasible and quick; it could be used clinically in sm all tumors not removable endoscopically.