Reverse Transrectal Stapling Technique Using the EEA Stapler:An Alternative Approach in Difficult Reversal of Hartmann’sProcedure

The introduction of circular end-to-end stapling devices(ceea or eea stapler) into colorectal surgery haverevolutionised anastomotic techniques. the eea stapler isgenerally regarded as an instrument that is safe, reliable,and simple to operate. despite it’s popularity, very littleinformation is available regarding the technical difficultiesencountered during surgery. the routine technique toperform an end-to-end circular colonic anastomosis isto introduce the instrument distally through the anus(transrectal/transanal approach) and attach it to the anvilwhich is purse stringed at the distal end of the proximal bowelto be anastomosed. two cases of reversal of hartmann’sprocedure for perforated diverticulitis are described in thepresent study, where difficulty was experienced while usingthe eea stapler in the routine method. hence, an alternativereverse technique which was used is presented.