A new mechanical device for circular compression anastomosis. Preliminary results of animal and clinical experimentation.

The authors report the preliminary results obtained in animal and clinical experimentation of a new mechanical device for circular anastomosis which they have developed. It is a gun that places an apparatus consisting of three polypropylene rings that, through the compression among them of the severed edges of the bowel, realize a sutureless anastomosis and are spontaneously evacuated. Fifty-eight colonic anastomoses were performed in dogs with this device; 23 stapled colonic anastomoses were also executed concurrently. Forty-four animals underwent a relaparotomy to remove the colonic specimen containing the anastomoses. Bursting pressure and the histologic features of the anastomoses were evaluated at different time intervals after operation. A good healing of all compression anastomoses was observed, thereby allowing them to initiate the experience in humans. Thirteen anastomoses (6 colorectal extraperitoneal, 1 colorectal intraperitoneal, 5 colocolonic, 1 ileorectal) were performed at the 1st Surgical Department, Milan University. One subclinical leakage (7.7%) spontaneously healed in a few days. No stenoses were observed.