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Updated: Aug 10, 2026
The C-seal: A Biofragmentable Drain Protecting the Stapled Colorectal Anastomosis from Leakage
Published on: November 4, 2010
A 10-year single-institutional study of the biofragmentable anastomosis ring
Kenneth A Forde1, Kristen H Goodell, Maryann DellaBadia
1Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. kaf2@columbia.edu
Background:
The biofragmentable anastomosis ring (BAR) was introduced by Hardy in 1985 as a simple alternative to sutured or stapled intestinal anastomosis.
Methods:
The aim of this study was to analyze complications related to the use of the BAR in elective intraperitoneal intestinal anastomosis to identify technical aspects important in the safe use of the device. The BAR was used by a single surgeon over a 10-year period. Three hundred fifty sequential intraperitoneal anastomoses were performed in 346 patients. There were 12 enteroenteric, 2 gastrojejunal, 199 enterocolic, and 137 colocolic anastomoses.
Results:
There was 1 suture line recurrent carcinoma but no strictures. There were 11 complications that appeared related to construction of the anastomosis, 2 of them resulting in death. The 2 patients who died both had cirrhosis with ascites. Eight patients required re-exploration for suspected anastomotic complications. Six of them recovered and were discharged.
Conclusion:
The BAR appears to be a safe alternative to sutured or stapled bowel anastomosis provided certain precautions are taken in its use.
