[Sutureless intestinal anastomosis with a biofragmentable anastomotic ring]

There have been efforts to develop an ideal method of intestinal anastomosis throughout medical history. In ancient China, Egypt and India living ants were used to approximate the transected edges of bowel. Many other devices and techniques have since been introduced, using organic or synthetic, nonabsorable or absorbable materials. Lately mechanical stapling devices have become exceedingly popular. The recently introduced biofragmentable anastomotic ring (BAR) is composed of an absorbable polyglycolic acid in 12.5% barium sulfate suspension to permit x-ray visualization. Prospective randomized studies have shown it to be both effective and safe as compared to conventional handsutured or stapled anastomosis. Its main advantages are simplicity and ease of handing, short operating time and the absence of foreign bodies at the anastomotic site that might interfere with imaging methods, such as CT or MRI. We present our preliminary, satisfactory experience with BAR in 14 patients with a mean age of 67 years. 8 underwent right colectomy, 2 left colectomy, 1 sigmoidectomy, 2 resection of upper rectum, 1 subtotal colectomy, 1 excision of a giant lymphoma of the cecum, and 1 had had recurrent bouts of volvulus of the sigmoid.