Treatment of Anastomotic Stricture of a Handsewn Coloanal Anastomosis With Transanal Approach

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This video details the treatment of anastomotic stricture of a handsewn coloanal anastomosis with the transanal approach instead of a combined abdominal and perineal approach.1,2 The patient underwent a laparoscopic total mesorectal excision with handsewn side-to-end coloanal anastomosis for rectal cancer. When the ileostomy was being prepared, we realized that the colon in the pelvis was ischemic. A decision to perform another anastomosis with a nonischemic part of the colon was made. Because the nonischemic part did not reach the anus, a laparoscopic Deloyers procedure was performed.3 A straight handsewn coloanal anastomosis was performed. A diverting loop ileostomy was done.
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