Scientific references
Evidence that informs
the rationale.
Selected literature supporting the biological rationale and scientific context of the Implican approach. The references are intentionally curated rather than exhaustive; they are not clinical evidence of safety, efficacy or superiority.
- 01Anastomotic healing
Morgan RB, Shogan BD. The science of anastomotic healing. Semin Colon Rectal Surg. 2022;33(2):100879. doi:10.1016/j.scrs.2022.100879.
- 02Anastomotic healing
Rosendorf J, Klicova M, Herrmann I, Anthis A, Cervenkova L, Palek R, et al. Intestinal Anastomotic Healing: What do We Know About Processes Behind Anastomotic Complications. Front Surg. 2022;9:904810. doi:10.3389/fsurg.2022.904810.
- 03Anastomotic healing
van Helsdingen CPM, Wildeboer ACL, Zafeiropoulou K, Jongen ACHM, Bosmans JWAM, Gallé C, et al. Histology and transcriptome insights into the early processes of intestinal anastomotic healing: a rat model. BJS Open. 2023;7(5):zrad099. doi:10.1093/bjsopen/zrad099.
- 04Anastomotic healing
Shogan BD, Carlisle EM, Alverdy JC, Umanskiy K. Do We Really Know Why Colorectal Anastomoses Leak? J Gastrointest Surg. 2013;17(9):1698–1707. doi:10.1007/s11605-013-2227-0.
- 05Submucosal apposition & compression healing
Jansen A, Becker AE, Brummelkamp WH, Keeman JN, Klopper PJ. The importance of the apposition of the submucosal intestinal layers for primary wound healing of intestinal anastomosis. Surg Gynecol Obstet. 1981;152(1):51–58. PMID: 7455891.
- 06Submucosal apposition & compression healing
Berho M, Wexner SD, Botero-Anug AM, Pelled D, Fleshman JW. Histopathologic Advantages of Compression Ring Anastomosis Healing as Compared With Stapled Anastomosis in a Porcine Model: A Blinded Comparative Study. Dis Colon Rectum. 2014;57(4):506–513. doi:10.1097/DCR.0000000000000009.
- 07Submucosal apposition & compression healing
Ore AS, Althoff A, Kull DR, Baldwin TJ, Van Eps JL, Messaris E. Comparative early histologic healing quality of magnetic versus stapled small bowel anastomosis. Surgery. 2023;173(4):1060–1065. doi:10.1016/j.surg.2022.11.030.
- 08Microbiome, collagen & leakage
Shogan BD, Belogortseva N, Luong PM, Zaborin A, Lax S, Bethel C, et al. Collagen degradation and MMP9 activation by Enterococcus faecalis contribute to intestinal anastomotic leak. Sci Transl Med. 2015;7(286):286ra68. doi:10.1126/scitranslmed.3010658.
- 09Microbiome, collagen & leakage
Hajjar R, Gonzalez E, Fragoso G, Oliero M, Alaoui AA, Calvé A, et al. Gut microbiota influence anastomotic healing in colorectal cancer surgery through modulation of mucosal proinflammatory cytokines. Gut. 2023;72(6):1143–1154. doi:10.1136/gutjnl-2022-328389.
- 10Microbiome, collagen & leakage
Cashin PH, Artursson S, Sköldberg F, Melhus Å. Association of the gut microbiome to colorectal anastomotic leakage: systematic review. BJS Open. 2026;10(2):zrag005. doi:10.1093/bjsopen/zrag005.
- 11Microbiome, collagen & leakage
Bosmans JWAM, Jongen ACHM, Birchenough GMH, Nyström EEL, Gijbels MJJ, Derikx JPM, et al. Functional mucous layer and healing of proximal colonic anastomoses in an experimental model. Br J Surg. 2017;104(5):619–630. doi:10.1002/bjs.10456.