ABSTRACT
Surgeons continue to be interested in identifying the best way to create an intestinal anastomosis. In 1893, Nicholas pointed out that ‘… the ideal method of uniting intestinal wounds is yet to be devised’. Through the years, surgeons have devised numerous types of suture material – absorbable, non-absorbable, synthetic, non-synthetic, braided and monofilament – to create intestinal anastomoses. Mechanical stapling devices might be traced to the early work of Denans in Marseilles, whose work preceded the more famous Murphy Button by 66 years. In 1826, he invaginated intestinal ends over two silver rings, and then approximated the bowel with a special pair of forceps. Inversion was accomplished and the entire circumferences of the serosal surfaces were opposed. Stapling devices were developed to overcome inadequacies with traditional suturing methods. Hulti produced a stapling instrument in 1911. It was cumbersome, weighed over 4.5 kg and took hours to assemble. Petz designed an instrument, similar to Payr’s crushing clamp, which placed a row of staples along both edges close to the stomach during gastrectomy. Between 1945 and 1950, a group of Russian engineers in Moscow, including Gudov and Androsov, developed methods to staple blood vessels together, prompted by the difficulties with traditional suture techniques experienced during the Second World War. Their developments continued up until the 1970s and included many gastrointestinal stapling instruments.1
