Anastomoses in Visceral Surgery-First Approach towards a Universal Transluminal System for Micro Invasive Application

The anastomosis of two bowel segments is one of the core competences in visceral surgery. However, postoperative complication rates and intraoperative trauma are still too high despite numerous methods and products available. The aim of this paper is to show the first approach towards the development of a transluminal system to enable micro invasive anastomosing just using natural orifices. In this context a requirements analysis based on expert discussions and literature evaluation focusing on postoperative complications was carried out. A testing model was developed and a pressure test setup was designed to derive optimal compression zone geometry, based on the material behavior of porcine bowel tissue. For the task of transluminal anastomization a highly adaptable and flexible system must be developed. From some initial experimental trials within an abstracted bowel model, we were able to reveal first promising results concerning feasibility of transluminal anastomosis generation. In the following an experimental protocol has to be developed to assess relevant parameters as a basis for an objective comparison of the different implant models.