To the Editor.—The end-to-end anastomosis circular stapling device (EEA) creates an inverted end-to-end anastomosis.1 A common difficulty with its use has been spasticity of the proximal bowel, preventing introduction of the distal end (anvil) of the stapling device. Foley catheter ballooning helps its introduction.
After performing a purse-string suture, a Foley catheter is inserted into the lumen of the bowel and the balloon is inflated with 10 to 15 mL of air (Figure, left). The inflation-deflation procedure is repeated several times to obtain good dilation of the bowel. The Foley catheter is withdrawn, three Allis clamps are attached to the edges of the bowel (Figure, right), and the anvil of the stapler is easily introduced.
Use of Foley catheter to assist in stapling of spastic bowel. Left, Foley catheter inserted into distal end of bowel and inflated to dilate bowel. Right, Foley catheter is withdrawn, Allis clamps attached,