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CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(04): 451-454
DOI: 10.1055/s-0041-1736295
Technical Note

Surgical Technique and Considerations about Transanal Transection and Single-Stapled (TTSS) Anastomosis: The Search for a Perfect Anastomosis

Fábio Guilherme Campos 
1   Colorectal Surgery Division, Gastroenterology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
,
Rafael Vaz Pandini 
1   Colorectal Surgery Division, Gastroenterology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
,
Leonardo Alfonso Bustamante-Lopez 
1   Colorectal Surgery Division, Gastroenterology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
,
Sérgio Carlos Nahas 
1   Colorectal Surgery Division, Gastroenterology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Abstract

The evaluation of preventive measures and risk factors for anastomotic leakage has been a constant concern among colorectal surgeons. In this context, the description of a new way to perform a colorectal, coloanal or ileoanal anastomosis, known as transanal transection and single-stapled (TTSS) anastomosis, deserves an appreciation of its qualities, and a discussion about its properties and technical details. In the present paper, the authors review the most recent efforts aiming to reduce anastomotic dehiscence, and describe the TTSS technique in a patient submitted to laparoscopic total proctocolectomy with ileal pouch-anal anastomosis for familial adenomatous polyposis. Surgical perception raises important advantages such as distal rectal transection under visualization, elimination of double-stapling lines (with cost-effectiveness and potential protection against suture dehiscence), elimination of dog ears, and the opportunity to be accomplished via a transanal approach after open, laparoscopic, or robotic colorectal resections. Future studies to confirm these supposed advantages are needed.

Keywords

colorectal anastomosis - rectal resection - single-stapled - transanal - transection


Publication History

Received: 28 May 2021

Accepted: 06 August 2021

Article published online:
13 December 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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