Rusian Science News

Source: www.informnauka.ru/eng

COMPRESSION SUTURE IN SURGERY

12/21/2008

Russian surgeons have developed a compression circular anastomosis
(CCA) apparatus that enables to quickly and reliably connect the esophagus
(cut during the operation) with the stomach or bowels. The invention is
covered by the patent of the Russian Federation.

Further information: Anatoly Robak, State-run Educational Institution –
Kurgan Regional Clinical Hospital; a_robak@mail.ru 

Russian surgeons – Anatoly Robak and Vladimir Ruchkin have suggested a new
way for surgical joint (anastomosis) of the esophagus with the stomach or
bowels. Physicians do not suture them manually by stitches but press to
each other with the help of a titanium nikelide spring. To install it, a
special compression circular anastomosis (CCA) apparatus was developed,
covered by the patent of the Russian Federation.

In case of stomach cancer, the target affected organ or its part is
removed. After the operation, it is necessary to suture the cut esophagus
to the remaining part of the stomach or bowels. It is very difficult to do
that. The stitches on the esophagus turn out to be precarious, they heal up
slowly, and are often infected by gut organisms. The invention enables to
avoid a manual suture.

The device that joins the oesophagus and the stomach consists of two
bowl-shaped rings, connected with each other by a 9-coil spring made of
titanium nikelide. It enables to reach the pressing force of 900 grams. The
chosen titanium nikelide alloy TiNi-10 is durable, plastic, biologically
inert. It becomes easily deformed when cooled below 4-5°С, when
heated up to 25°С, it restores the initial shape. A protective
sleeve is inside the apparatus, upon which the connectable organs are
fixed. Specialists of the Limited Liability Company Research-and-Production
Enterprise – Youth Information Center (Tomsk) have produced an apparatus of
20, 22 and 24 millimeters in diameter to join organs of different sizes.

The first experiments were carried out on outbred dogs in the clinic of
animals at the Russian Scientific Center of Restorative Traumatology and
Orthopaedy named after Academician G.A. Ilizarov. Esophagogastric
anastomosis was made under anaesthetic. It takes 45 minutes to connect the
esophagus to the stomach if the organs are connected by a manual stitch.
Application of the compression apparatus allows to reduce the required
period by three times. As a radiographic investigation has proved, the
devices disjoint on the 4-6th day after the operation, and fall into the
stomach. With big dogs, the devices went through the pylorus, freely moved
along the gastrointestinal tract, being excreted from the organism in a
natural way.

During the first critical week after the operation, durability of the
junction formed by the CCA apparatus exceeded durability of the manual
suture by 1.2-1.7 times. Gut organisms appeared in the compression suture
only during the first three days after the operation, there were 14.3 times
less bacteria than in a manual suture.

The CCA apparatus developers believe that it is simple, comfortable and
reliable in application, it ensures high mechanical strength and biological
impermeability of the junction.

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