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Laparoscopic subtotal colectomy with antiperistaltic caecorectal anastomosis in severe slow transit constipation — a video vignette

Slow transit constipation is a severe form of chronic constipation characterized by prolonged colonic transit time which affects greatly the patients' quality of life. Usually, dietary changes, increased fiber intake and laxatives represent the first medical approach, nevertheless a small number of patients are not responsive to nutritional and pharmacological therapy: for those patients only, a surgical approach can be considered. A subtotal colectomy with antiperistaltic cecorectal anastomosis offers advantages in terms of absorption of water, electrolytes, bile salts and vitamin B12 obtained by preserving ileocecal junction, terminal ileum and caecum. We present our minimally-invasive surgical technique for subtotal colectomy with antiperistaltic cecorectal anastomosis. The post-operative course was smooth. Eight months after the intervention the patient reported 2-3 bowel-movement per day and semi-liquid faeces. The technique explained allows for a feasible minimally invasive subtotal colectomy with antiperistaltic cecorectal anastomosis.