• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Intracorporeal versus Extracorporeal Anastomosis in Minimally-Invasive Rectosigmoid Resection

Intracorporeal versus Extracorporeal Anastomosis in Minimally-Invasive Rectosigmoid Resection

Kasim Mirza, MD, Carey Wickham, MD, Andreas M Kaiser, MD, FACS, FASCRS. USC Colorectal Surgery

Introduction: Intracorporeal anastomosis (ICA) during minimally invasive colorectal resections (robotic/laparoscopic) has been thought to have advantages over extracorporeal anastomosis (ECA). It avoids exteriorization of the colon with room air exposure, traction, and manipulation in the resection and anastomosis phase and for placement of an EEA stapler anvil. We previously described the technique of a robotic single-dock intracorporeal anastomosis for rectosigmoid resections. The purpose of this study was to compare outcomes between robotic and laparoscopic ICA and ECA for sigmoid and low anterior rectal resections (LAR). We hypothesized that ICA was associated with decreased rates of ileus and LOS.

Methods: Patients who between 2015 and 2018 underwent a laparoscopic or robotic sigmoidectomy or LAR performed by a single surgeon at a tertiary referral center were retrospectively analyzed. Included were any minimally-invasive sigmoidectomy or LAR for benign or malignant disease with primary stoma-free anastomosis. ICA was defined as laparoscopic or single-dock robotic resection with intracorporeal colon resection and anvil placement, whereas ECA was defined as exteriorization of more than the specimen for resection, anvil placement, or anastomosis. Exclusion criteria included conversion from MIS to open surgery, creation of a stoma, or hand-sewn coloanal anastomosis.

The patients were grouped into ICA versus ECA. Data analyzed and compared included patient demographics, operative time, peri- and postoperative morbidity, and length of stay. Statistical analysis was performed on SAS software using 2-tailed t-test for continuous variables, and chi-squared or fisher exact test for categorical data.

Results: Of 64 patients identified, 40 met the criteria with 20 ICA (10 LARs and 10 sigmoidectomies) and 20 ECA (17 LARs and 3 sigmoidectomies). There were no significant differences between the groups for age, gender, ASA, or BMI. Average LOS was shorter in ICA (3.5 vs 5.3 days) without reaching statistical significance (p=0.088). While the rate of prolonged postoperative ileus showed no difference, overall complications were significantly higher in ECA (8/20 vs 2/20,=p=0.029). Responsible for this difference was a significantly lower complication rate after ICA for LARs when compared to ECA (p=0.026). Without reaching statistical significance, secondary outcomes such as operative time (254 vs 231 min,p=0.24) and leak rate (2/20, 0/20,p=0.49) favored ICA.

Conclusion: Minimally-invasive ICA was associated with favorable outcomes compared to ECA with significantly decreased overall post-operative complications and a trend to shorter LOS without an increase in operative time. ICA for rectosigmoid resections appears to offer an advantage and should be further evaluated


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95959

Program Number: P287

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

View this Poster

448

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals