Editor's note:

In response to the Belt and Road Initiative, and with the aim of sharing expertise and addressing shared health challenges, our hospital has launched the Overseas Promotion Program for New Medical Technologies. If you are interested in any of the medical technologies covered under this program, please feel free to contact the International Cooperation Office at faowch@163.com.

U-tied functional end-to-end anastomosis (UEEA)

Currently intracorporeal anastomosis (IA) during the totally laparoscopic colectomy (TLC) for colon cancer patients broadly includes time-consuming and technically demanding manual anastomosis, as well as stapled approaches that requires multiple cartridges and entails complex standardization. Based on this, our team developed a novel intracorporeal anastomosis method, U-tied functional end-to-end anastomosis (UEEA), which simplifies the anastomosis procedure and requires only 1-2 stapler cartridges.

After mobilization, a ligation band was applied to tie the proximal and distal bowel segments in parallel, forming a “U-shape” configuration of the specimen. Enterotomies were created at the antimesenteric region of the proximal and distal bowel ends and a 60 mm Echelon Flex linear cutting stapler was then used to complete the bowel anastomosis. The ends of the common opening were closed using either sutures or titanium clips to prevent retraction. The bowel resection and closure of the stump were completed concurrently using another stapler. The specimens are bagged and removed through a small auxiliary incision or natural orifice.

Its core innovation involves the use of a "U-shaped ligation" to align and fix the bowel segments in parallel prior to anastomosis, which reduces the risk such as tumor compression, mesenteric traction bleeding, and anastomotic twisting; Precise identification of ischemic boundaries and the use of indocyanine green ensure an adequate blood supply to the anastomotic site; reliable reinforcement techniques reduce the risk of anastomotic leakage; restrictive bundling methods and innovative cleaning protocols minimize bowel content spillage and abdominal contamination. The bagged specimen is extracted via a small abdominal incision or natural orifice, which minimizes the trauma. Based on the findings of the IDEAL stage 2a study, the UEEA technique reduces operative time, ensures high surgical safety, and results in a low 30-day postoperative complication rate with no severe complications. All procedures achieved oncological radical resection (R0), and patients exhibited rapid postoperative recovery.

UEEA represents a significant advancement in minimally invasive colorectal surgery. Its standardized approach shortens the learning curve (proficiency achieved after ~35 cases) and ensures consistent, high-quality anastomotic outcomes, making it highly suitable for adoption in diverse clinical settings. UEEA offers a cost-effective solution for nations where the burden of colon cancer is rising, without compromising patient safety or oncological results. Its reliability, combined with enhanced recovery benefits, makes it an exemplary technology for improving surgical care standards and attracting international patients seeking high-quality, affordable medical innovation.