Retracting the peritoneum laterally
With the patient rotated to the left in steep Trendelenburg position, the surgeon retracts the peritoneum laterally while the assistant retracts the right colon medially.
Attaching the anvil to the circular stapler
The anvil is attached to the circular stapler (which has been passed transanally); the stapler will be closed and fired in the usual fashion.
The anvil of the circular stapler
A. The anvil of the circular stapler is inserted in the proximal end of the bowel (which has been drawn out of the abdomen through an enlarged trocar site). B. The pursestring suture is tied. The bowel is then returned to the abdomen.
The endoscopic linear stapler
The endoscopic linear stapler is used to divide the bowel at the distal resection margin.