NEW ANASTOMOSIS TECHNIQUE FOR (LAPAROSCOPIC) INSTRUMENTAL SMALL-DIAMETER ANASTOMOSIS

This study presents a new technique for visceral anastomosis. The prin ciple consists of connecting the two parts to be anastomosed around a reabsorbable stent which is transluminally introduced into a small-dia meter viscus, where it is fixed. Advancing a larger tube along the axi s of the machine, the larger, perforated viscus is inverted and pulled over the stent, and finally a rubber band pops off the machine endolu minally in order to fix the intestinal walls in seroserosal contact on to the stent. To evaluate this ''micro'' anastomosis, a biliary bypass (choledochojejunostomy and roux-en-y-loop) was performed in ten pigs. Nine of ten animals showed biliary bypass with good runoff in contras t radiography and completely reabsorbed stent after a 3-month follow-u p. Weight gain, bilirubin, and alkaline phosphatase were normal. This technology demonstrates a safe and quick way to perform instrumental ' 'micro'' anastomosis without remnant foreign material.