Multiple Application of the Bioabsorbable Anastomosis Ring in Gastrointestinal Surgery

Abstract

The first mechanical intestinal anastomosis that had broad clinical application was performed by means of the Murphy button (Murphy 1892, 1894, 1893–1894). This method, which was preceded by publications of experiments by Denans (1827) and Henroz (1826) at the beginning of the century, was developed at Chicago and was acknowledged worldwide at that time. A Chicago surgeon, Senn, also dealt with mechanical intestinal anastomoses (Senn 1889, 1893). He wrote in 1893: “We have reason to believe that the technique of intestinal suturing remains an unfinished chapter, and that the ideal method of uniting intestinal wounds has yet to be devised.” He himself worked on wafershaped bone plates decalcified by hydrochloric acid for side-to-side anastomoses and, as early as 1889, he established the following requirements for mechanical intestinal anastomoses: “Any internal aids to circular suturing should be composed of absorbable material and employed in such a way as not to produce marginal gangrene and with a central opening large enough large enough to allow free faecal circulation.“ An anastomosis ring fulfilling these requirements was devised by Hardy et al. (1985). The results of its experimental application were stimulating. First clinical applications of Valtrac, the bioabsorbable anastomosis ring (BAR), and studies on the colon (Hardy et al. 1987; Corman et al. 1989) confirmed this concept for clinical use.