[Manual suture versus/or mechanical suture from the German viewpoint]

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery
• Thoracic Surgery

Background:

• Stapled sutures have seen increased application in gastrointestinal and lung surgeries.
• Modern staplers represent a high level of technical perfection, with origins in the early 20th century.
• The introduction of circular staplers around 1978/79 marked a significant breakthrough.

Purpose of the Study:

• To highlight the impact of stapled sutures, particularly circular staplers, in modern surgery.
• To discuss innovations in gastrointestinal reconstruction enabled by circular staplers.
• To acknowledge the established use of circular staplers in rectal surgery and emerging manual suture techniques.

Main Methods:

• Review of the application and technical development of stapled sutures.
• Analysis of surgical reconstruction principles in gastrointestinal surgery facilitated by circular staplers.
• Consideration of current practices in rectal stapler use and alternative manual suturing methods.

Main Results:

• Circular staplers have led to significant advancements in gastrointestinal tract surgery.
• Standardized procedures for substitute stomach formation (e.g., Roux-Y, pouch) are now possible.
• Circular staplers are widely accepted for rectal procedures, though manual sutures are also noted.

Conclusions:

• Modern staplers have greatly improved surgical techniques in the gastrointestinal tract and lungs.
• Circular staplers have enabled innovative and standardized reconstructive procedures, offering new physiological perspectives.
• While stapler use is prevalent, advancements in manual suturing materials warrant attention.