The proximal colon was divided where it appeared morphologically normal and the mesenteric division was completed. A bag was introduced into the abdomen and the specimen was extracted by extending the umbilical incision. The proximal bowel end was then delivered into the umbilical incision and trimmed of pericolic fat. The staple line was excised and the lumen measured with sizers. A 28 mm anvil was placed and secured with a polypropylene purse string suture. After irrigation, the colon was dropped into the abdomen. The port site was irrigated, the fascia closed around the port, and the pneumoperitoneum reestablished.
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The end to end stapler was introduced through the rectum up to the distal staple line. The trochar tip was advanced and can be seen as the white dot below the staple line.
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