A stapling instrument is described for end-to-end inverting anastomoses applicable principally to low rectal anastomosis or esophagogastric or esophagojejunal anastomosis. The instrument creates an inverting anastomosis held by a double staggered row of stainless steel wire staples creating an anastomosis 21.2 mm internal diameter with no significant inverted flange. The early experience is encouraging.
SUMMARYFollowing the original introduction of an automatic stapling instrument producing B-form staples by de Petz (1924, 1927)~ there has been derived from the very important first generation of Soviet stapling instruments a second generation of American stapling instruments characterized by: (I) the use of preloaded, pre-sterilized, and disposable staple cartridges; ( 2 ) the adaptability of one instrument to a variety of cartridges for use in a variety of tissues and operative situations; (3) the transfer from the instrument itself to the disposable cartridge of delicate and fragile moving parts simplifying the maintenance and operation of instruments. The instruments have found wide and satisfactory application in numerous areas of thoracic, vascular, gastro-intestinal, and gynaecological surgery.
tional surgical approaches to this problem are discussed. A technique for laparoscopic repair of a Morgagni hernia is described. The literature on the laparoscopic repair of a Morgagni hernia is reviewed and different operative techniques are discussed.
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