Treatment of a Total Obstructive Anastomosis Stricture Using a Transanal Laparoscopic Approach and Intraoperative Colonoscopic Balloon Dilatation

• Published in: Annals of coloproctology Vol. 36; no. 5; pp. 353 - 356
• Main Authors: Kwak, Jae Young, Yang, Kwan Mo, Seo, Hyun Il
• Format: Journal Article
• Language: English
• Published: Korean Society of Coloproctology 01-10-2020; 대한대장항문학회
• Subjects: anastomosis; balloon; Case Report; stricture; transanal; 일반외과학
• ISSN: 2287-9714; 2287-9722
• DOI: 10.3393/ac.2020.02.27

An anastomosis stricture with a total obstruction is rare and treatment options are variable. We describe our experience with a combination of a single port transanal laparoscopic approach and intraoperative colonoscopic balloon dilatation. The patient was a 48-year-old man with rectal cancer. A laparoscopic single port lower anterior resection and diverting ileostomy were performed followed by a colon study and ileostomy takedown. The colon study and sigmoidoscopy revealed total obstruction of the rectum at the anastomosis level. We employed a transanal approach using a single port to correct this. We located the anastomosis stricture site and generated a lumen using a dissector and electocautery method to insert the balloon device. Colonoscopic balloon dilatation was subsequently successful. The patient was discharged with no postoperative complications. A laparoscopic single port transanal approach with an intraoperative colonoscopic balloon dilatation is a viable alternative approach to treating an anastomosis stricture of the rectum.