Research progress on intestinal anastomosis technology and related devices

This review comprehensively examines current intestinal anastomosis techniques. Traditional manual suturing methods, including intermittent and continuous sutures, provide high flexibility but but vary in infection risk and operation time. Continuous suturing is particularly effective in reducing operative time and infection risk. Suture materials include non-absorbable sutures, absorbable sutures, and natural materials, with absorbable sutures the most preferred for intestinal anastomosis. Mechanical anastomosis has gained widespread adoption, featuring both linear and circular metal staplers. Linear staplers are simple to operate, while circular staplers better align with physiological structures. Materials used in staplers include non-degradable metals (e.g., titanium, titanium alloy) and biodegradable anastomosis (e.g., magnesium alloy). Metal nail anastomosis often results in fewer complications than manual suturing in specific surgeries. Magnetic pressure anastomosis, relying on magnet attraction, has been successfully applied in clinical scenarios following extensive research. The adhesive-based approach involves medical adhesives such as cyanoacrylate and fibrin glue, offering auxiliary support for anastomosis. Energy tissue welding encompasses laser and radio frequency energy tissue welding. While laser welding poses a risk of thermal damage, radio frequency welding offers significant advantages, including faster, seamless anastomosis with reduced complications. The support method for intestinal anastomosis is a novel concept, involving the addition of support materials to the original anastomosis. It can be divided into composite and simple support methods. The simple support method, as evidenced by the "degradable internal scaffold method for digestive tract anastomosis" developed by Cai et al. in China, has demonstrated promising results in animal experiments. In conclusion, selecting the appropriate intestinal anastomosis technique depends on clinical scenarios to optimize surgical outcomes and reduce complications. The diverse technological advancements reviewed here present valuable opportunities for enhancing the quality and safety of intestinal surgery.