EEA stapled end-to-end anastomosis

Once an appropriately sized circular stapler has been selected, the anvil of the stapler is introduced into the proximal end of the bowel by removing the staple line if present (A). A purse-string suture is used to close the lumen around the anvil. The EEA stapler is advanced through the anus and opened, which advances the guidepost to pierce the rectal wall (B). After attaching the anvil to the guidepost, the stapler is then closed. That retracts the guidepost along with the anvil toward the rectus, thus approximating the two bowel ends (C). Once the stapler is adequately closed, it is fired and removed through the anus (D).