Early experiences with magnetic rings in resection of the distal colon.

We have developed an anastomosis technique for resection of the distal colon based on the principle of submucosal layer apposition. The anastomosis apparatus consists of two rings of Ertalyte (polyester-polyethyleneterephtalate) containing two magnetic rings of polymer bonded rare earth cobalt. For low anastomoses we developed a magnetic ring holder, protecting cap and hexagonal connecting rod. The working principle is based on progressive compression leading to necrosis of the intermediate mucosal and submucosal layers by increasing magnetic force while bowel healing takes place. After 7 to 17 days the magnets cut through and are propelled by peristalis out of the anastomotic region. From our initial series of five patients we performed three sigmoid resections and two low anterior resections. There were no postoperative complications. Sigmoidoscopic and radiological investigations two weeks postoperatively, showed no evidence of leakage or anastomotic narrowing. The technique and the special advantages of the apparatus are discussed.