Evolution of the mechanical suture.

The mechanical suture is a semi-automatic anastomosis of tissues by means of a stapler. The above-mentioned refers to the anastomosis of tissues using mechanical or absorbable clips. In recent years the structure of suturing equipment is constantly developing. Worldwide, one may observe the growing interest of the mechanical suturing technique. The nineteenth century includes the development of science and chemical industry, which largely contributed to the modification of materials used in case of suturing. The first absorbable synthetic sutures were based on polyvinyl alcohol, and appeared in the early thirties of the past century, manufactured by B. Braun Melsungen in cooperation with Wacker Chemie. In 1946 and 1949 polyamidecoated (Supramid) sutures were introduced into clinical practice by BASF, while between 1950 and 1951 synthetic, collagen sutures (Collafil). Further experience in this direction showed that polyacids can be used to manufacture absorbable sutures with exceptionally favorable properties. In the seventies of the past century one observed the introduction of a glycol acid suture (Dexon) into hospitals throughout the world. The above-mentioned suture was modified in 1979 and named Dexon S. Currently, many medical sectors are engaged in manufacturing suturing material. They are considered as the basic material for closing surgical wounds, modified depending on their intended use, being subject to continuous development, according to the latest scientific knowledge (1). The rapid development of surgery that took place over the centuries did not resolve issues concerning alimentary tract continuity disruption. Manual suturing methods thus far used, often did not prove successful, due to the development of complications, such as inflammation, irritation of the operated area, and leakage of the intestinal anastomosis. This was the reason why surgeons tried to construct a mechanical device that would replace the already existing manual mechanism. In 1826, the Belgian surgeon Henroz attempted the above-mentioned by severing the dogs bowels and joining them by means of special rings. More than 60 years later, in 1892, an American surgeon from Chicago, John B. Murphy constructed a device, which joined the lumen of the gall-bladder with the duodenum (2). The above-mentioned device was named “Murphy’s button”, consisting of two sleeves stapled together. They provided good adhesion of the anastomosed organ walls. Later on the device was applied in gastric and intestinal surgery. Davis & Geck in the eighties of the past century developed a Biofragmentable Anastomotic Ring-Valtrac® (1).