A self-locking loop as an alternative to purse-string suture in colon anastomosis: a feasibility study

BACKGROUND: Colorectal cancer is common in humans where treatment involves surgical removal of the cancerous part of the intestines. In the anastomosis procedure a purse-string suture may be time consuming to perform. The aim was to replace the purse-string suture, to develop and test a self-locking loop for temporary sealing of the lumen in colon anastomosis. METHODS: A new device, a flexible band with a locking mechanism was constructed, the I-Tie(®). Small protrusions, designed for increased friction between device and tissue, were added to one side of the flexible band in order to enhance the grip at closure of the loop around tissue. The device was initially tested in vitro on pig intestines. In an in vivo study, the short-term implant was tested in a new suture-free method, CREX, and with traditional circular staplers for colonic anastomosis. Ten female pigs of approximately 50 kg were used in the in vivo test. The self-locking device was used for closure of the lumen around anvils in CREX (n = 5), and around anvil in traditional circular stapler anastomosis (n = 5). Two self-locking devices were used in each animal. RESULTS: The self-locking device could close the lumen of colon around the anvil and trocar. Subjectively, the device achieved a tight closure of the colon and did not interfere with the anastomosis techniques. CONCLUSIONS: The technology was perceived as potentially timesaving and easy to use. We conclude the device may be an alternative to the traditional purse-string suture for temporary closure of the colon lumen in colon anastomosis.