Intracorporeal stapled ileocolic anastomosis with mechanical closure of the enterotomy after laparoscopic right colectomy for cancer: Keep it Simpler.

Laparoscopic colectomy has become the standard practice for colorectal cancer surgery. A variety of techniques are described for anastomosis including extracorporeal and intracorporeal techniques. Intracorporeal anastomosis may be associated with better cosmesis and post-operative recovery. However, the review by Reddavid et al. (J Gastrointest Surg 24:2389-2392, 2020) describing an intracorporeal stapled technique for ileo-colonic anastomosis has several issues. First, the technique for forming intracorporeal anastomoses is not novel and has been previously reported. The conversion rate to open surgery does not relate to anastomosis technique but the difficulty of dissection and tumour stage. Furthermore, performing the technique requires an additional trocar adding to expense. Moreover, utilizing multiple sutures which close the enterostomy prior to stapling does not stand scrutiny when the defect has already been closed. The additional staple firing is a risky strategy particularly if the stapler splits. Thus, it is vital that new techniques promoted to trainees and residents have a sound technical and evidence base, avoid unnecessary expense or risk technical failure.