Gingold B S, Cooper M L, Wallack M K
St. Vincent's Hospital and Medical Center, New York, New York, USA.
Dis Colon Rectum. 1995 Dec;38(12):1322-4. doi: 10.1007/BF02049159.
The use of the circular stapler has enabled surgeons to perform very low anterior resections where previously abdominoperineal proctectomy would be performed for carcinoma of the rectum. The use of the roticulator or other linear stapler devices has facilitated these anastomoses and precluded the necessity for pursestring sutures, thereby reducing the incidence of incomplete tissue rings, which should reduce the risk of anastomotic leaks. One significant drawback to the roticulator, especially in the narrow male pelvis, is its application for very low lesions. In many cases the stapler cannot be forced deeply enough into the pelvis to allow for a sufficient margin below the tumor.
The purpose of this article is to report results of a prototype that applies a gasket that automatically fixes the rectum to the rod of the circular stapler.
To date the device has been used 22 times in 14 patients (8 patients had both limbs attached using the device, whereas 6 patients had only the rectal stump attached in this manner).
All anastomoses healed without complication, all patients had complete donuts of tissue, and only two anastomoses had to be reinforced.
The use of this device may facilitate stapling of very low anastomoses for carcinoma of the rectum.
圆形吻合器的使用使外科医生能够进行超低位前切除术，而在以前，对于直肠癌患者需行腹会阴联合直肠癌根治术。旋转吻合器或其他线性吻合器装置的使用简化了这些吻合操作，不再需要荷包缝合，从而减少了不完全组织环的发生率，这应该会降低吻合口漏的风险。旋转吻合器的一个显著缺点，尤其是在男性骨盆狭窄的情况下，是其在超低位病变中的应用。在许多情况下，吻合器无法足够深入地插入骨盆，以在肿瘤下方留出足够的切缘。
本文的目的是报告一种应用垫片将直肠自动固定在圆形吻合器杆上的原型器械的使用结果。
迄今为止，该器械已在14例患者中使用了22次（8例患者的双端均使用该器械连接，而6例患者仅以这种方式连接直肠残端）。
所有吻合口均愈合且无并发症，所有患者均有完整的组织环，仅2个吻合口需要加固。
该器械的使用可能有助于进行超低位直肠癌吻合术的吻合操作。
