Mechanical sutures in esophageal replacement: fashion or resource?*

Complete mechanical cervical anastomosis using a narrow gastric tube after esophagectomy for cancer

“…With the aim of reducing the incidence of this specific complication, at the end of the 2000 we started to perform a cervical totally mechanical anastomosis using an endoscopic linear stapler, based on the technique previously proposed by Collard et al [6] and Orringer et al [7]. Experimental studies [8,9] demonstrated that the diameter of the anastomosis using linear stapler was greater than that obtained with circular stapled or manual anastomosis with lower incidence of late fibrous stenosis. Nevertheless, the employment of linear stapler GIA was limited because of the large dimension of the device when used for cervical anastomosis.…”

Mechanical digestive anastomosis: a new technique to make it easier, quicker and more reliable

“…Other techniques, such as the mechanical purse‐string clamp 1,4 the double and triple staple technique combining a mechanical linear suture with a mechanical circular suture 3,5 or a loop stitch 1 have been suggested to overcome this problem. However, they are either more complicated and expensive to perform than the manual purse‐string suture or leave the surgeon with a degree of uncertainty about the quality and durability of the method of tying the tissue and concerns about the integrity of the resulting donut 1,4…”

“…This has contributed not only to an improved quality of anastomosis but also has significantly reduced operation times. We believe this new technique has the potential to be extended to the laparoscopic approach to digestive anastomoses 3,4 …”

“…Mechanical suturing devices facilitate the performance of digestive sutures and, nowadays, are accepted by the great majority of surgeons not just as a means of reducing surgical time but also as a way of simplifying and making safe the technically more difficult aspects of manual suturing 1–3 …”

“…Mechanical suturing devices facilitate the performance of digestive sutures and, nowadays, are accepted by the great majority of surgeons not just as a means of reducing surgical time but also as a way of simplifying and making safe the technically more difficult aspects of manual suturing. [1][2][3] These beneficial aspects were particularly observed when performing digestive anastomoses and more specifically the anastomosis of the esophagus, colon or rectum, which are usually the areas most likely to experience postoperative fistulous tracts.…”