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[Digestive anastomosis in general surgery]

C Natale1, L Ferrozzi, C Pellegrino

  • 1Divisione di Chirurgia Generale, Ospedali Riuniti di Foggia, Azienda Ospedaliera.

Il Giornale Di Chirurgia
|June 17, 1998
PubMed
Summary
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Digestive anastomoses remain debated, with mechanical sutures offering advantages in difficult access but hand-sewn techniques still valuable. Surgeons must choose the best method for each case, balancing innovation with proven techniques for safe intestinal anastomosis.

Area of Science:

  • Surgical Techniques
  • Gastrointestinal Surgery
  • Suture Materials

Background:

  • Digestive anastomoses are a subject of ongoing debate regarding optimal surgical techniques.
  • The introduction of mechanical sutures has intensified discussions comparing them to traditional suturing methods.

Purpose of the Study:

  • To compare the peculiar aspects of mechanical and hand-sewn suture techniques for digestive anastomoses.
  • To review advancements in both mechanical sutures and suture materials.
  • To present the authors' experience and specific techniques in various gastrointestinal surgeries.

Main Methods:

  • Comparative analysis of mechanical and hand-sewn anastomotic techniques.
  • Review of recent progress in suture technology and mechanical staplers.

Related Experiment Videos

  • Description of a personal hand-sewn technique using polydioxanone (PDS) suture for gastrointestinal reconstruction.

    • Main Results:

    • Mechanical sutures have improved in handling and anastomosis resistance.
    • Suture threads have become more inert and stronger.
    • The authors detail their experience in esophagogastric, small intestine, colon-rectum, hepato-biliary, and pancreatic surgeries, including a specific extramucosal continuous suture technique.

    Conclusions:

    • Mechanical sutures have facilitated new therapeutic solutions and access to challenging surgical sites.
    • Surgeons need to discern when mechanical sutures are unnecessary and manual techniques offer equivalent safety and speed.
    • The choice between mechanical and hand-sewn anastomosis depends on the specific clinical scenario and surgeon's expertise.