Colon transection and anvil insertion

For an intracorporeal colorectal anastomosis, the bowel is transected distally first. The EEA anvil is inserted into the bowel through an antimesenteric colostomy created distal to the point of proximal transection. Approximately 2 cm proximal to the proximal point of transection, a small pinpoint colotomy is created to allow the anvil post to exit. The larger colotomy is closed with a running barbed suture, and the bowel is then transected at the proximal point of transection. Alternatively, the anvil post can be pulled through the transverse staple line of the proximal transection. Both techniques are illustrated in this video compilation.