Compression Anastomoses Revisited

Aggarwal, Rajesh; Darzi, Ara

doi:10.1016/j.jamcollsurg.2005.06.255

Cited by 50 publications

(40 citation statements)

References 60 publications

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“…The development of compression anastomosis began with Denan in 1826 followed by the simpler metallic Murphy's button in 1892 [3,4,7,8]. The Russians made the AKA-2 device in 1984 and Hardy and colleagues developed the Valtrac ring in 1985 [3,4,7,8,9,10,11,12,13,14,15,16,17]. In 2006, a nickel-titanium shape memory ring device was described in the literature [5,18,19,20,21,22].…”

Section: Discussionmentioning

confidence: 99%

“…In 1892, Murphy described a sutureless anastomosis (‘Murphy's button') consisting of two hollow steal cylinders. Although used for several decades, Murphy's button was abandoned due to difficulties in expelling the device and frequent obstructions [3,4,7,8]. Nonetheless, the concept developed by Murphy would form the basis for future compression devices for intestinal anastomoses.…”

Section: Introductionmentioning

confidence: 99%

“…The BAR functions similarly to the Murphy's button by holding the two divided intestines together after securing the intestinal ends to the BAR with a purse-string suture. Although the feasibility and safety of using the BAR have been documented in numerous prospective and follow-up studies [3,4,7,8,9,10,11,12,13,14,15,16,17], the BAR turned out to be cumbersome to use and gained limited support among surgeons. Recently, a new compression device made of nickel-titanium (nitinol) shape memory rings has been reported to be safe and effective in the creation of colorectal anastomoses [5,18,19,20,21,22].…”

Section: Introductionmentioning

confidence: 99%

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The Compression Anastomotic Ring-Locking Procedure: A Novel Technique for Creating a Sutureless Colonic Anastomosis

et al. 2014

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Background/Aim: Compression anastomoses might represent an improvement over traditional hand-sewn or stapled techniques. Herein, we describe a novel concept of sutureless colonic anastomosis named compression anastomotic ring-locking procedure (CARP). Materials and Methods: The surgical device consists of two anastomotic rings and their associated helping tools, facilitating the placement of the rings into the intestinal ends. Furthermore, four catheters are connected to the surgical device, allowing the evaluation of the anastomosis during and after surgery. A total of 31 pigs underwent a low colocolic anastomosis using the anastomotic rings. The compression pressure was measured perioperatively and up to 96 h after surgery. Anastomotic integrity and morphology were analyzed by use of radiology and histology, respectively. A long-term follow-up was conducted in a subgroup of pigs up to 108 days after surgery when the bursting pressure and stricture formation were examined. Results: All animals recovered uneventfully, and macroscopic examination revealed intact anastomoses without signs of pathological inflammation or adhesions. The perioperative compression pressure was inversely proportional to the gap size between the anastomotic rings. For example, an anastomotic gap of 1.5 mm created a colonic anastomosis with a perioperative compression pressure of 91 mbar, which remained constant for up to 48 h and resulted in a markedly increased compression pressure. Contrast infusion via the catheters effectively visualized the anastomoses, and no leakage was detected within the study. The surgical device was spontaneously evacuated from the intestines within 6 days after surgery. Histology showed collagen bridging of the anastomoses already 72 h after surgery. Long-term follow-up (54-108 days) revealed no stricture formation in the anastomoses, and the bursting pressure ranged from 120 to 235 mbar. The majority of bursts (10/12) occurred distant from the anastomoses. Conclusion: We conclude that the surgical device associated to CARP is safe and efficient for creating colonic anastomoses. Further studies in patients undergoing colorectal surgery are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Compression Anastomotic Ring-Locking Procedure: A Novel Technique for Creating a Sutureless Colonic Anastomosis

et al. 2014

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“…The innovation of CAC is the shape memory nitinol double ring that becomes flexible in cool water and resumes its programmed shape when warmed by body temperature. Technical failure rates of a new technique must be reduced by eliminating the learning curve on a suitable animal model [13] . In our study, no intraoperative problems were observed and no additional supportive measures were needed, suggesting that the increasing experience with our previous animal experiments may significantly shorten the duration of technique learning.…”

Section: Discussionmentioning

confidence: 99%

Compression anastomosis clip for gastrointestinal anastomosis

Liu

Jiang²,

Zhu³

et al. 2008

WJG

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“…For a long time hand suture has been used. Current routine surgery practice deals with using staplers for mechanical suture to create a uniform anastomosis [1]. Sutureless anastomosis using the shape memory clips ensure anastomosis that is highly resistant to leakage which may cause sepsis.…”

Section: Introductionmentioning

confidence: 99%

Two-way shape memory-clips for colonic anastomosis

Morawiec

Lekston

Lampe

et al. 2009

ESOMAT 2009 - 8th European Symposium on Martensitic Transformations

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Abstract. The compression anastomosis clip (CAC) is an elliptic shape double-ring device produced from nickeltitanium shape memory alloy. Until now the CAC works basing on the one-way shape memory effect. The aim of presenting studies was finding out the technology of two-way shape memory (TWSME) clips formation which should fulfil the requirements for clinical application. The clips were formed by wires of an alloy with 51.02 at. % Ni balance Ti. The best value of the TWME and uniform compression force of the clips was achieved by combining deformation, constrained aging and thermomechanical cycling.

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Compression Anastomoses Revisited

Cited by 50 publications

References 60 publications

The Compression Anastomotic Ring-Locking Procedure: A Novel Technique for Creating a Sutureless Colonic Anastomosis

The Compression Anastomotic Ring-Locking Procedure: A Novel Technique for Creating a Sutureless Colonic Anastomosis

Compression anastomosis clip for gastrointestinal anastomosis

Two-way shape memory-clips for colonic anastomosis

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