Achievement of haemostasis following a double-stapled (Knight–Griffen) anastomosis using the transanal endoscopic operating system – a video vignette

Postoperative colorectal anastomotic bleeding is not uncommon following colonic surgery. Endoscopic procedures are usually safe, efficient and successful. The use of endoscopic clips or direct injection of sclerosing agents guarantees accurate haemostasis. Endoscopic electrocoagulation may also be used to deal with anastomotic haemorrhage 1-5. We present a case of a patient undergoing a sigmoid colectomy for diverticulosis. On the first postoperative day, bleeding occurred from the double‐stapled (Knight–Griffen) anastomosis. Initial management was with endoscopic clips but further bleeding occurred after 12 h. At this stage, we decided to use the transanal endoscopic operating (TEO) system. With the patient in the supine position, the bleeding point was identified and a continuous suture used to under‐run the area in question, using a resorbable self‐locking monofilament suture. This was successful with no recurrent bleeding. The TEO system can be an additional valuable aid but must be used by experienced surgeons.