Work

Deloyers’ Maneuver for Colorectal Anastomosis: What Can We Do When the Colon Cannot Be Lowered?

Year: 2024

Type: article

Abstract: Introduction This video presents the Deloyers' Maneuver, which involves the mobilization and counterclockwise rotation of the right colon followed by an anastomosis with the rectum. This procedure may be necessary after extensive colon resections when lowering the transverse colon alone is not feasible due to tension. Objective To provide a didactic and replicable demonstration of the Deloyers' procedure after extensive colectomy. Case Presentation A patient presented with complaints of rectal bleeding and underwent a colonoscopy, which revealed synchronous lesions in the rectum and left colon. Staging for colorectal cancer showed no evidence of distant metastases, and MRI indicated T2N0 malignancy in the rectum. Combined resection of both lesions was planned. During surgery, the high tension in the lowered transverse colon prevented a safe colorectal anastomosis, making the Deloyers' Maneuver necessary. The Video The video demonstrates the procedure step by step in a didactic manner, showcasing this important maneuver, which is not typically the first choice in standard colorectal resections. It is reserved for more complex cases, particularly in extensive colectomies. The video illustrates the full mobilization of the right paracolic gutter, the counterclockwise rotation of the ascending colon, and the mechanical anastomosis with the rectum using a 29mm circular stapler. Conclusion In colorectal surgery, the Deloyers' Maneuver is an essential tool for colorectal surgeons, offering one of the most critical strategies to avoid tensioned anastomoses in extensive colorectal resections. This safe and reproducible technique enables adequate colorectal anastomosis in challenging cases. Publication History Article published online: 25 April 2025 © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

Source: Journal of Coloproctology

DOI: 10.1055/s-0045-1808916