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Research progress on intestinal anastomosis technology and related devices

Yilong Chen, Lin Mao, Zijie Zhou, Chengli Song 


Shanghai Institute for Minimally Invasive Therapy, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China.


Address correspondence to: Lin Mao, Shanghai Institute for Minimally Invasive Therapy, School of  Health Science and Engineering, University of Shanghai for Science and Technology, Yangpu District,  Shanghai 200093, China. Tel: +86-21-55572159. E-mail: linmao@usst.edu.cn.


DOI: https://doi.org/10.61189/314845qnicsc


Received January 19, 2025; Accepted February 19, 2025; Published March 31, 2025


Highlights

● Continuous suturing in traditional manual suturing shortens operation time and reduces infection risk. Absorbable sutures are preferred for intestinal suturing and anastomosis to minimize foreign body reactions.

● Mechanical anastomosis with linear and circular metal staples offers distinct advantages, while new biodegradable staples demonstrate good performance. 

● Magnetopressure anastomosis, leveraging magnetic attraction, has shown success in specific scenarios, providing innovative approaches to intestinal anastomosis. 

● Radio frequency energy tissue welding technology enables rapid, seamless intestinal anastomosis, with   fewer complications and holds strong potential for future applications. 

● The support method for intestinal anastomosis, particularly the "degradable internal stent anastomosis" using a simple support method, shows significant promise in animal studies.

Abstract

This review comprehensively examines current intestinal anastomosis techniques. Traditional manual suturing  methods, including intermittent and continuous sutures, provide high flexibility but but vary in infection risk and  operation time. Continuous suturing is particularly effective in reducing operative time and infection risk. Suture  materials include non-absorbable sutures, absorbable sutures, and natural materials, with absorbable sutures the  most preferred for intestinal anastomosis. Mechanical anastomosis has gained widespread adoption, featuring  both linear and circular metal staplers. Linear staplers are simple to operate, while circular staplers better align  with physiological structures. Materials used in staplers include non-degradable metals (e.g., titanium, titanium alloy) and biodegradable anastomosis (e.g., magnesium alloy). Metal nail anastomosis often results in fewer complications than manual suturing in specific surgeries. Magnetic pressure anastomosis, relying on magnet attraction,  has been successfully applied in clinical scenarios following extensive research. The adhesive-based approach  involves medical adhesives such as cyanoacrylate and fibrin glue, offering auxiliary support for anastomosis. Energy tissue welding encompasses laser and radio frequency energy tissue welding. While laser welding poses a risk of thermal damage, radio frequency welding offers significant advantages, including faster, seamless anastomosis with reduced complications. The support method for intestinal anastomosis is a novel concept, involving the addition of support materials to the original anastomosis. It can be divided into composite and simple support methods. The simple support method, as evidenced by the “degradable internal scaffold method for digestive  tract anastomosis” developed by Cai et al. in China, has demonstrated promising results in animal experiments. In conclusion, selecting the appropriate intestinal anastomosis technique depends on clinical scenarios to optimize  surgical outcomes and reduce complications. The diverse technological advancements reviewed here present  valuable opportunities for enhancing the quality and safety of intestinal surgery.

Keywords: Intestinal anastomosis technique, manual suture, mechanical anastomosis, magnetic pressure anastomosis, support anastomosis

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Yilong Chen, Lin Mao, Zijie Zhou, Chengli Song. Research progress on intestinal anastomosis technology and related devices. Prog in Med Devices 2025 Mar; 3(1) : 66-76. doi: 10.61189/314845qnicsc
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