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By R. Gullichsen (auth.), Prof. Dr. Rainer Engemann, Prof. Dr. med. A. Thiede (eds.)

Biofragmentable anastomoses earrings symbolize a desirable inspiration: Stan­ dardization of anastomoses, safe method in program, expulsion of the fabric with no residuals. moreover, one unmarried method permits to accomplish the classical finish to finish, finish to aspect, and aspect to facet anastomoses in so much parts of the gastrointestinal tract, with none auxiliary software. this suggests a superb benefit of practicability. managed stories evidenced that the speed of problems is especially small for the intestinal tract. for this reason, it is very important identify the localization for current indication and contra­ symptoms. chapters in particular take care of higher GI anastomoses in­ cluding esophagus anastomoses and with BAR anastomoses in inflammatory bowel ailment. this is often performed through analysing the knowledge and through an alternate of expertise among the scientific examine teams. This e-book is to communi­ cate experimental information and to extend knowing approximately pathophysiology of the therapeutic of anastomoses via compression anastomoses. Wiirzburg, Germany, Prof. Dr. R. ENGEMANN October 1994 Prof. Dr. A. THIEDE Contents Experimental study Histological and scientific facets of Early therapeutic of the Valtrac Anastomosis within the Colon R. GULLICHSEN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . three Colorectal Intramural Blood offer and Microcirculation in guy M. A. R. AL FALLOUJI (With five Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Biofragmentable Anastomosis Ring as opposed to Stapled Anastomoses within the Extraperitoneal Rectum: Experimental learn in canines N. G. CZECZKO, B. POLONIO, L. F. COLA

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Extra resources for Compression Anastomosis by Biofragmentable Rings: Proceedings of the Second European Workshop

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In performing the stitches, the tunica adventitia, the tunica muscular, and the tela submucosa were included and the tunica mucosa excluded. In the BAR group the procedure was an esophageal transection and a compression anastomosis; one of the most important steps in performing a BAR anastomosis is the placement of the purse-string suture at the ends of the organ. This purse-string guarantees the early stability of the anastomosis. The purse-string was done by hand with 3/0 Maxon with an atraumatic T-5 (26-mm) needle.

In the BAR group one dog had a mucosal aspect classified as regular, in three animals it was good, and in eight dogs the aspect of the mucosa was excellent (Figs. 2-4). Biofragmentable Anastomosis Ring Versus Stapled Anastomoses 21 Fig. 2. Gross macroscopic view of the mucosa on the fifth postoperative day Fig. 3. Gross macroscopic view of the mucosa on the 15th postoperative day Histology In the stapler group, microscopic observation revealed good healing in one dog and regular healing in three animals on the fifth postoperative day; there was an intense acute transmural inflammatory reaction, with microabscesses surrounding the place where the staples were.

Kerr HH (1923) The development of intestinal surgery. JAMA 81:641-647 12. Lembert A (1826) Memoire sur l'enteroraphie avec la description d'un procede nouveau pour pratiquer cette operation chirurgicale. Rep Gen Anat Physiol PathoI2:100-107 13. Maney JW, Katz AR, Li LK, Pace WG, Hardy TG (1988) Biofragmentable bowel anastomosis ring: comparative efficacy studies in dogs. Surgery 103:56-62 14. McAdams JW, Meikle AG, Taylor JO (1970) One layer or two layer colonic anastomoses? Am J Surg 120:546-550 15.

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