SLIDING, ABSORBABLE, REINFORCED RING AND AN AXIALLY DRIVEN STENT PLACEMENT DEVICE FOR SUTURELESS FIBRIN GLUE GASTROINTESTINAL ANASTOMOSIS

Reduced blood flow of from 43 to 71% has been reported in sutured and stapled anastomoses. The sutureless sliding, absorbable, intraluminal, nontoxic stent (SAINT)-fibrin glue anastomotic method, which clamps t he stump margins between 2 dissolving surfaces, includes only two stag es of temporary compression (about 6 min total using 4 IU/mL thrombin) during the glue application in order to promote vascularization. A SA INT placement device (SAINT-PD) was introduced to facilitate low recta l anastomoses. Morphohistologic results from limited trials using fibr in glue with an untied sutureless stapler technique and a prototype no n-gear-driven SAINT-PD, neither having the two dissolvable clamping su rfaces of the SAINT, showed a 29 and 25% incidence of intraluminal tis sue ridges, respectively. Since these tissue ridges could result in su bclinical dilatation or frank stenosis, and the more extensive SAINT t rials had an 8% incidence of tissue ridges, redesign of the SAINT-PD w as undertaken. Consequently, to improve the anastomotic quality of the SAINT-PD, the sliding absorbable reinforced ring (sucrose base) actin g as the second dissolvable surface for the SAINT-PD and a new axially controlled geared SAINT-PD design are described.