The concept of anastomosis without suture is not new. The ideal device for sutureless bowel anastomosis contains no foreign material, is easy and quick to construct, is safe even in cases of increased intraluminal pressure and causes virtually no
granulation tissue or scarring. The Valtrac(r) biofragmentable anastomosis ring wa sintroduced to fulfill theses criteria in 1985.
Thirty bowel anastomoses were attempted in 28 patients with a Valtrac(r) biofragmentable anastomosis ring (BAR) for sutureless bowel anastomosis. Patients ranged in age from 14 to83 year(mean 5.30), with following diagnoses: Primary colon cancer,
12;
previous colostomy, four; benign colon ulcer, three; colopelvic renal fistula, liposarcoma of jejunum, leiomyoma of jejunum, cystic jejunal duplication, traumatic jejunal perforation, bladder tumor, transsexualism, primary gastric cancer,
recurrent
gastric cancer, tuberculous contracted bladder, one each. Operations were performed as elective in 21 and emergency in 7. Anastomoses performed were enterocolic(n=17), colocolic or colorectal (n=9), and enteroenteric(n=4).
In one patient the BAR was aborted and a new BAR anastomosis was performed because of concern with the blood supply to the anastomosis due to relatively extensive mucosal tear. One patient developed anastomotic leak which required hartmann-type
reoperation. There was one death (due to acute renal failure) in hospital.
The average duration from operation to resumption to regular diet was 11.7 dyas.
The BAR seems to be a safe and reliable alternative to conventional suture anastomosis bowel surgery.
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