The assesment of techniques of bowel anastomosis in laparoscopic colorectal surgery: an observational prospective study.

Laparoscopic colorectal surgery has gained momentum over the last one and a half decade and has become the standard procedure for both colonic and rectal tumors. Colorectal anastomotic leak is one of the most feared post operative complications after any anastomosis made on the bowel. However different techniques of anastomosis have been studied viz a viz the bowel anastomosis leak rate. The various techniques performed for restorative bowel anastomosis are End to End (EE), End to side(ES) and Side to Side(SS). The physiological and anatomical anastomosis however, difficult to perform is End to End anastomosis as it maintains the continuity of the bowel and less leak rate is reported thereby. We took up a study and became interested in evaluating the techniques of anastomosis with the objectives of technical feasibility, return of bowel sounds and time of completion with each technique. Our results were quite satisfying as only one patient (3.8%) in our series developed leak in the technique of Side to Side anastomosis which is the most favoured and commonly performed bowel anastomosis in laparoscopic colorectal surgery. Due to small sample size we could not better evaluate the return to bowel sounds in each technique.