Mechanical vs Manual Anastomosis

Abstract

Mechanical and manual anastomosis are two widely used techniques in surgical procedures for joining tissue segments, particularly in gastrointestinal surgery. Mechanical anastomosis, which utilizes stapling devices, offers advantages such as reduced operative time and, in certain procedures, lower rates of complications like anastomotic fistulas and wound infections. However, it has been associated with a higher incidence of anastomotic strictures. In contrast, manual anastomosis provides greater precision and flexibility, making it preferable in cases with poor tissue quality or complex surgical fields, such as pediatric and emergency general surgery patients.

The learning curve for manual anastomosis is steep, requiring extensive training and experience. Simulation-based training and mentorship have been shown to improve proficiency and reduce complications such as anastomotic leakage. The choice between mechanical and manual techniques should be based on patient-specific factors, surgical complexity, and surgeon expertise. As surgical advancements continue, further research into optimizing anastomotic techniques will be essential to improving outcomes and minimizing complications.