[Viscerosynthesis: the realization of an old dream. A look at the 150-year development of surgical suture techniques]

In analogy with osteosynthesis in bone surgery, viscerosynthesis has been introduced as a term for intestinal tissue fixation by staplers. As a result of continuous research, the development of mechanical suture instruments started early in the 19th century. At that time the base of manual suture technique was described by A. Lembert (1826), which is still applicable today. Simultaneously F. Denans introduced a device for intestinal anastomosis. An impressive variety of instruments was developed since then, which resulted in 1893 in the construction of the successful J. Murphy anastomotic button. Derived from it several more elaborate instruments were constructed until recently for oesophageal and rectal anastomoses as well. Entirely new of conception was the stapler apparatus by H. Hültl in 1906, succeeded shortly after by von Petz' stapler clamp. Inspired by them the Russians developed since World War II a tremendous instrumentarium. From 1959 the Americans took over and delivered highly specialized and technologically outstanding stapler instruments which currently dominate the market. Referring to the preceding generations of surgeons, one might say that with the advent of those instruments an old dream has been realized.