Magnetic compression anastomosis can compress tissues together and restore the continuity. Magnetic compression anastomosis mainly experienced three stages: magnetic ring, magnetic ring and column, and smart self-assembling magnets for endoscopy (SAMSEN). Nowadays, the magnetic compression anastomosis has been applied in vascular and different digestive tract surgeries, especially for complex surgery, such as anastomotic stenosis of biliary ducts after liver transplantation or congenital esophageal stenosis. Although only case reports are available at present, the advantages of the magnetic compression anastomosis includes lower cost, simplicity, individualization, good efficacy, safety, and minimally invasiveness. We are building a better technical platform to make magnetic compression anastomosis more advanced and popularized.
Anastomosis, Surgical ; methods ; Digestive System Surgical Procedures ; methods ; Humans ; Magnetics

Malignant or benign diseases of stomach are very common in China. The application of laparoscopy surgery in gastric diseases is a remarkable symbol of current gastric surgery. Laparoscopic assisted radical gastrectomy has gained widespread acceptance for the treatment of gastric cancer. Total laparoscopic radical gastrectomy, which means the gastric resection, lymph nodes dissection and gastrointestinal anastomosis are entirely performed in intracorporeally, is the inheritance and progression of laparoscopic assisted radical gastrectomy. However, controversy still exists regarding the risk and difficulty of intracorporeal anastomosis. In Asian countries including China, total laparoscopic radical gastrectomy has not been extensively performed yet. This review focuses on the issues related to intracorporeal gastrointestinal reconstruction in laparoscopic procedure, such as its history and current status, as well as the surgical technique and risk.
Anastomosis, Surgical ; methods ; Gastrectomy ; methods ; Humans ; Laparoscopy ; methods

This paper describes some new concepts and new technologies about the current colorectal surgery, such as minimally invasive, bloodless surgery, no touch technique, and some new techniques of gastrointestinal anastomosis. Meantime, bloodless technique and closed resection in our clinic practice are introduced. These new concepts and new techniques widely used improve significantly the efficacy of colorectal surgery.
Anastomosis, Surgical ; Colorectal Surgery ; methods ; Humans ; Minimally Invasive Surgical Procedures

Surgery remains the cornerstone of treatment for esophageal cancer, although improvements have been made in surgical maneuvers and perioperative care, serious complications still occur after operation. The reconstruction of alimentary tract is a key procedure to ensure success of operation, it is related to perioperative complication and prognosis. Selection of procedure should be individualized based on the stage and location of the disease, medical condition and the surgeon's experience.
Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans

Recently, total gastrectomy has been increasingly used for gastric cancer. However, it remains controversial as to the optimal technique for reconstruction after total gastrectomy. As of now, more than 70 reconstruction techniques following total gastrectomy have been reported, and each model has its own merits and demerits. Currently no ideal digestive reconstruction exists. The cores of these controversies are how to improve the postoperative quality of life on the basis of oncological and operative safety. The controversies focus on the following three aspects: (1) necessity of physiological duodenal passage; (2) necessity of a gastric pouch; (3) the optimal pouch configuration. Evidence-based medicine with large sample, multicentric, prospective randomized control trials is warranted.
Anastomosis, Surgical ; methods ; Gastrectomy ; methods ; Humans ; Stomach Neoplasms ; surgery

Anastomosis, Surgical ; methods ; Humans ; Microsurgery ; methods ; Microvessels ; surgery

With the development of laparoscopic skills and instruments,totally laparoscopic gastrectomy for gastric cancer has become widely used in the clinic,mainly including totally laparoscopic proximal gastric reconstruction,distal gastrectomy for gastric cancer and total gastrectomy. Digestive tract reconstruction is the key procedure of totally laparoscopic gastrectomy for gastric cancer. Totally laparoscopic surgery has less trauma and better visualization than reconstruction in a small incision. At present,feasibility and safety of totally laparoscopic gastrectomy for gastric cancer have been preliminarily confirmed. However,higher level of evidence is needed for the evaluation of long-term oncologic efficacy. In the future,it is possible for patients to best benefit from totally laparoscopic surgery with minimal trauma,safe anastomosis under the principle of radical resection of gastric cancer. The digestive tract reconstruction includes Delta anastomosis (Billroth I),Billroth II anastomosis,and gastrojejunal Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy (TLDG). Billroth I with delta anastomosis has strict indications in TLDG. Gastrojejunal Roux-en-Y anastomosis is now more popular. Billroth II with Braun anastomosis and uncut Roux-en-Y anastomosis is technically easier to carry out in TLDG than Roux-en-Y. Totally laparoscopic proximal gastric reconstruction includes esophagogastric stump anastomosis,esophagogastric tubular anastomosis and interposition jejunostomy. The digestive tract reconstruction includes anastomosis using linear stapler and circular stapler in totally laparoscopic total gastrectomy (TLTG). In order to better serve the clinic,we review the progress of different endoscopic anastomotic techniques and digestive tract reconstruction.
Anastomosis, Surgical ; methods ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Stomach Neoplasms ; surgery

Methods of digestive tract reconstruction after distal gastrectomy include Billroth I, Billroth II and Roux-en-Y. Each of them has advantages and disadvantages respectively. Alkaline reflux gastritis (ARG) is one of the complications after distal gastrectomy, which is common after Billroth II. In the past 100 years, the ways of digestive tract reconstruction have been continuously improved and developed to prevent the occurrence of alkaline reflux gastritis, and Roux-en-Y is one of them. Still, there is a high incidence of Roux stasis syndrome resulting from Roux-en-Y, with impact on quality of life. Therefore, the appropriate reconstruction is needed urgently. Braun anastomosis was proposed in 1892 to lower the incidence of afferent syndrome. Because of its effect of diverting some alkaline digestive juice, it was applied to pancreaticoduodenectomy and distal gastrectomy. Some studies have proved its effect of diverting some alkaline digestive juice, but the diverted quantity was rarely shown. Besides, compared with Roux-en-Y, Billroth II with Braun anastomosis is safer and more convenient. Meantime it is likely to have benefits in aspect of preventing anemia and malnutrition. In order to provide evidence to clinical practice, this article summarizes the history and research advance of Billroth II with Braun anastomosis by reviewing previous reports.
Anastomosis, Roux-en-Y ; Anastomosis, Surgical ; Gastrectomy ; methods ; Gastroenterostomy ; methods ; Humans ; Quality of Life ; Stomach Neoplasms ; surgery

In recent years, laparoscopic total gastrectomy is gradually increasing for gastric cancer. Digestive tract reconstruction after laparoscopic total gastrectomy is one of the difficult problems for laparoscopic surgeons and the keys to success. Therefore, exploring an ideal method of digestive tract reconstruction is an important subject for clinical treatment. Reasonable choice and techniques of digestive tract reconstruction after laparoscopic total gastrectomy are summarized and evaluated in this article.
Anastomosis, Surgical ; methods ; Digestive System Surgical Procedures ; methods ; Gastrectomy ; methods ; Humans ; Laparoscopy ; methods

BACKGROUNDA new procedure of colonic anastomosis with a degradable stent has already been proven to be simple, feasible, and safe in our porcine model. In this study, we evaluated its impact on the colonic physiologic functions.

METHODSA total of 20 pigs were assigned randomly to either a stent anastomosis group (SA, n = 10) or a conventional anastomosis group (CA, n = 10). Colonic anastomosis with a degradable stent was performed in the SA group, and conventional hand-sewn anastomosis was performed in the CA group. Body weight, fecal weight, total colonic transit time, immunohistochemistry staining of interstitial cells of Cajal (ICC), plasma diamine oxidases (DAO) levels, and Western blotting analysis of occludin were evaluated before and after anastomosis.

RESULTSNo obvious diarrhea or constipation was observed in all pigs. No significant difference in body weight between the groups was detected at any time. Yet, the fecal weight was less in the CA group compared with the SA group on postoperative day (POD) 7. No observable colonic paralysis or retention occurred. For total colonic transit time, there was no significant difference between the two groups at any time or among different time points in the same group. The integrated optical density of ICC showed no significant difference on either POD 14 or 30. The plasma DAO levels were remarkably elevated after surgery, and began to decrease since POD 3. However, there was no significant difference between both two groups in plasma DAO levels at any time either. For both groups, the expression of occludin was not significantly different from their pre-surgery level on either POD 14 or 30.

CONCLUSIONSAccording to these results, this procedure with a degradable stent was supposed to be the same as the conventional hand-sewn procedure in their impact on the colonic physiologic functions.