Recanalization of rectal anastomosis atresia with magnetic compression anastomosis

Recanalization of rectal anastomosis atresia with magnetic compression anastomosisA 71-year-old man underwent radical resection of rectal cancer and ileostomy 11 months prior.Two weeks ago, an ileostomy closure was planned; however, a colonoscopy revealed atresia of the rectal anastomosis.The patient came to our hospital seeking a magnetic surgical treatment technique.Following colonoscopy and colonography, which clearly demonstrated rectal anastomotic atresia ( Fig. 1), we developed a detailed treatment plan of magnetic compression anastomosis ( Fig. 2).The procedure was performed after the patient and his family signed the informed consent form.Following anesthesia, an endoscope was inserted into the colon through the ileostomy; however, reaching the proximal end of the atresia proved challenging.Consequently, a Zebra guidewire was introduced through the biopsy hole to navigate as close as possible to the proximal end of the atresia.The guidewire was maintained in position while the colonoscope was withdrawn.The tail end of the guidewire passed through the side hole of the daughter magnet, which was then advanced along the guidewire using the endoscope to approach the proximal end of the atresia as closely as possible.Sub-E-Videos Fig. 1 The atresia of the rectum.a Colonoscopy.b, c Colonography. Fig. 2 Surgical planning.a The daughter magnet (DM) and the parent magnets (PMs) were inserted through the ileostomy and anus, respectively.b The daughter magnet and parent magnets attracted together. Fig. 3 Insertion of the daughter magnet.a The guidewire passed through the side hole of the daughter magnet.b The daughter magnet was pushed towards the proximal end of the atresia by endoscope.c The status of the daughter magnet observed by X-ray.d The daughter magnet was pushed as proximal to the atresia as possible.