[Use of a new compression circular mechanical stapler in surgery of the large intestine]

Clinical application in surgery of the large bowel of a compression anastomotic device developed by the Authors is described. The device consists of three plastic rings carried by an instrument that assembles the rings while the bowel is being joined. The rings remain by the anastomotic site until complete healing of anastomosis, then fall into the intestinal lumen and are evacuated with the feces. Sixty-nine patients underwent large bowel anastomosis using this device in our department from May 1986 through June 1989. Forty percent of the anastomoses were located at less than 8 cm from the anal verge. Five intraoperative diverting colostomies were performed (7.2%). The rings were evacuated in average 11 days after the operation, with no or very little discomfort. Operative mortality was 1.4% (one patient died of myocardial infarction). Anastomotic complications were: two (2.8%) clinical and two (2.8%) subclinical dehiscences. This initial clinical experience shows that the anastomotic device is reliable.