Lee AY, Cho JY. Clinical diagnostic advances in intestinal anastomotic techniques: Hand suturing, stapling, and compression devices. World J Gastrointest Surg 2024; 16(5): 1231-1234 [PMID: 38817301 DOI: 10.4240/wjgs.v16.i5.1231]
Corresponding Author of This Article
Joo Young Cho, PhD, Academic Editor, Division of Gastroenterology, Department of Internal Medicine, Cha Gangnam Medical Center, Cha University College of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul 06135, South Korea. cjy6695@naver.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2024; 16(5): 1231-1234 Published online May 27, 2024. doi: 10.4240/wjgs.v16.i5.1231
Clinical diagnostic advances in intestinal anastomotic techniques: Hand suturing, stapling, and compression devices
Ah Young Lee, Joo Young Cho
Ah Young Lee, Joo Young Cho, Division of Gastroenterology, Department of Internal Medicine, Cha Gangnam Medical Center, Cha University College of Medicine, Seoul 06135, South Korea
Author contributions: Lee AY conceptualization, writing-original draft, formal analysis, investigation, and editing; Cho JY conceptualization, supervision, writing-review, and editing and final approval of the article.
Conflict-of-interest statement: Ah Young Lee, and Joo Young Cho have no conflicts of interest or financial ties to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joo Young Cho, PhD, Academic Editor, Division of Gastroenterology, Department of Internal Medicine, Cha Gangnam Medical Center, Cha University College of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul 06135, South Korea. cjy6695@naver.com
Received: December 29, 2023 Revised: February 5, 2024 Accepted: April 28, 2024 Published online: May 27, 2024 Processing time: 145 Days and 11.3 Hours
Abstract
The development of intestinal anastomosis techniques, including hand suturing, stapling, and compression anastomoses, has been a significant advancement in surgical practice. These methods aim to prevent leakage and minimize tissue fibrosis, which can lead to stricture formation. The healing process involves various phases: hemostasis and inflammation, proliferation, and remodeling. Mechanical staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic chemokines. Compression anastomosis devices, including those made of nickel-titanium alloy, offer a minimally invasive option for various surgical challenges and have shown safety and efficacy. However, despite advancements, anastomotic techniques are evaluated based on leakage risk, with complications being a primary concern. Newer devices like Magnamosis use magnetic rings for compression anastomosis, demonstrating greater strength and patency compared to stapling. Magnetic technology is also being explored for other medical treatments. While there are promising results, particularly in animal models, the real-world application in humans is limited, and further research is needed to assess their safety and practicality.
Core Tip: The development of techniques for the creation of intestinal anastomoses, such as hand suturing, stapling, and compression anastomoses, represents a significant advancement in surgical practice. Compression anastomosis devices reduce inflammation compared to sutured anastomosis, and they yield leakage and stenosis rates similar to those of standard sutured and stapled colorectal anastomoses. Recent reports suggest that these devices facilitate the safe and efficient creation of intestinal anastomoses. For instance, compression anastomoses have exhibited a greater bursting strength and wider patency than stapled anastomoses, even after chemoradiotherapy. Nevertheless, the potential of compression anastomosis, including its safety and practicality, warrants further investigation.