Division of the Small Bowel with the LigaSure Atlas Device During the Right Laparoscopic Colectomy

Abstract

Bowel division and anastomosis were facilitated greatly with the advent of stapling techniques. Since then, there have not been any new evolving technologies to facilitate these maneuvers. For this reason, we recently applied the LigaSure Atlas device (Valleylab, Boulder, CO) to the division of the small bowel during this procedure to obtain a reliable and low-cost division of the ileum. After vessel ligation and ileocolic mobilization, the terminal ileum is sealed and divided with the LigaSure Atlas. This device is applied sequentially along the small bowel twice to ensure an adequate seal before the cut. A terminolateral ileotransversostomy is performed extracorporeally with a mechanical circular stapling device, installing the anvil of the circular stapler into the ileal stump. We have not encountered any problems with this technique since its introduction in our institution, and no leakage or bursting of the ileal stumps. This technique enables an easy, reliable, and inexpensive technical option to optimize the right laparoscopic colectomy procedure.