Copyright ©2010 Baishideng.
World J Gastroenterol. Apr 7, 2010; 16(13): 1610-1621
Published online Apr 7, 2010. doi: 10.3748/wjg.v16.i13.1610
Table 1 Characteristics of the four main compression devices
ApplicationLaparoscopy, laparoscopy, transanalTransanalLaparotomy, laparoscopy, hand-assisted lapLaparotomy, laparoscopy, hand-assisted lap
Internal Lumen11-2025, 28, 318One ring size (27 mm) replaces a number of competitive sizes (25-34 mm)
Average time to expulsion (d)14-214-677-10
Type of surgery
Foreign body reactionNoPossible to metal pinsNoNo
Tissue healingExtensive fibrosis/may cause strictureExtensive fibrosis/may cause stricturePrimary intention/no strictures reportedPrimary intention/no strictures reported (recovery of multi-layer lumen structure)
Anastomotic indexLumen capacity depends upon standardized ring sizeFull lumen capacity within 8-12 wk
EfficacySafe and secure and can be applied to achieve multiple anastomosis (in case requiring rapidity and security)
Learning curve1Technically difficult than the other three devicesTechnically simple after education
Cost2About $600NAAbout $3NA (however higher than conventional staples)
Tissue thickness accommodationSelecting ring size to be compatible with diameter and thickness of bowel wallSame as BAROnly one size, shape memory alloy that accommodates varies tissue thickness. Unique thermo-mechanical properties and super elasticity
Type of anastomosisEnd-to-end, end-to-side, side-to-sideSide-to-sideEnd-to-end
Site of anastomosisSuitable for intestinal, colonic and rectal anastomosisDistal colon and rectal onlyIntestinal, colonic and rectal anastomosis
Table 2 Compression anastomosis: clinical experience and complications
StudyDeviceEmergency/electiveAnastomotic leakageObstructionStricture
Bubrick et al[34]BAR0/39512 (3.2%)18 (5%)-
Cahill et al[35]BAR0/1012 (2%)4 (4%)-
Corman et al[36]BAR0/2226 (2.7%)9 (4%)2 (0.9%)
Gullichsen et al[37]BAR--13 (16%)-
Seow-Choen et al[39]BAR-002 (10%)
Di Castro et al[49]BAR90/4241704 (1%)
Thiede et al[33]BAR0/136034 (2.5%)--
Pahlman et al[38]BAR24/262 (4%)3 (6%)-
Ghitulescu et al[53]BAR23/1367 (4.2%)13 (7.9%)3 (1.8%)
Kim et al[45]BAR101/5155 (0.8%)13 (2.1%)1 (0.5%)
Wullstein et al[40]AKA-270/37211 (2.5%)-2 (0.5%)
Nudelman et al[43]CAC0/5000
Nudelman et al[42]CAC0/30000
Nudelamn et al[44]CAC0/10000
Liu et al[59]CAC0/33000
Table 3 List of reinforcement materials[64]
MaterialStapler typeCompany
Non-absorbableePTFELinearW.L. Gore, Elkton, MD, USA
Semi-absorbableBovine pericardium (peristrips dry)Circular linearSynovis Life Technologies, Inc.
Porcine small bowel (surgisis)LinearCook Biotech Inc.
AbsorbablePolyglycolic acid:trimethylene carbonate (seamguard bioabsorbable)Linear circularW.L. Gore & Associates, Inc.
Cellulose (Xcell)LinearXylos Corp.
Knitted calcium alginate (foreseal)LinearLaboratoires Brothier, Nanterre, France