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. 2020 Dec 20;78:204–209. doi: 10.1016/j.ijscr.2020.12.059

Fig. 4.

Fig. 4

Anastomosis by the double stapling technique.

(a) The staple at the stump of the oral side intestine is excised.

(b) Purse string suture using 2-0 prolene (Ethicon) in the abdominal cavity.

(c) Inserting the anvil head into the open stump.

(d) Tying the thread and fixing the anvil head. A circular endostapler (intraluminal stapler/ILS, Ethicon) is introduced through the anus, and anastomosis is performed.