Anastomosis Devices: Enabling Minimally Invasive Surgeries
Anastomosis is the surgical connection of two hollow organs or vessels in the body. It involves connecting or reconnecting tubular structures together after resection to restore passage. Some common types of anastomoses include intestinal anastomoses during bowel resections, vascular anastomoses during coronary artery bypass graft surgery, and tracheal anastomoses during lung resections. Performing anastomoses is an important and delicate part of many surgical procedures.
Types of Anastomoses
There are two main types of anastomoses - end-to-end and end-to-side. In an end-to-end anastomosis, the cut ends of two tubular structures are joined together directly. This is commonly done for intestinal anastomoses. In an end-to-side anastomosis, the cut end of one tubular structure is joined to the side of another tubular structure. Vascular anastomoses during CABG are usually end-to-side.
Manual vs Stapled Anastomoses
Traditionally, anastomoses were performed manually using surgical sutures. This required great technical skill and was time-consuming. It also involved larger incisions. The introduction of anastomosis devices has enabled stapled or mechanical anastomoses to be performed more easily and quickly. There are mainly two types of Anastomosis Devices - circular staplers and linear staplers.
Circular Staplers
Circular staplers are used to perform end-to-end anastomoses of hollow organs such as intestines and blood vessels. They apply a ring of stainless steel staples combined with a continuous buttress to join the cut ends. This is done through a small insertion site, compared to open surgery. Circular staplers come in varying sizes depending on the organ diameter. They are reusable after sterilization and offer reliability.
Linear Staplers
Linear or linear cutting staplers are used for end-to-side anastomoses. They are often used in vascular surgery to connect a graft to an artery or vain. The device fires rows of staggered staples to join the tissue and provides a neat linear edge. They help create a wider lumen for blood flow. Linear staplers also come in varying sizes and shaft lengths based on surgical needs.
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