Safe and quick distal pancreatectomy using a staggered six-row stapler
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Updated: Jul 9, 2026

Laparoscopic Pancreatoduodenectomy for Pancreatic Cancer Using In-Situ No-Touch Isolation Technique
Published on: February 2, 2022
Takeyuki Misawa1, Hiroaki Shiba, Teruyuki Usuba
1Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan. take-misawa@jikei.ac.jp
Background:
The use of stapling devices for distal pancreatectomy remains controversial, due to concerns about the development of postoperative pancreatic fistula (POPF) and hemorrhage.
Methods:
We report herein the usefulness of the Endo SGIA stapler (Tyco Healthcare, Norwalk, CT) for distal pancreatectomy by placing 2 triple-staggered rows, ie, 6 rows of staples in the pancreatic stump. The pancreas was divided together with both the splenic artery and vein with Endo SGIA in 7 consecutive hand-assisted laparoscopic distal pancreatectomies.
Results:
No patients developed clinically significant POPF or postoperative hemorrhage. None of the patients had complications that may have influenced the length of hospital stay.
Conclusion:
The 6-row Endo SGIA stapler allows quick and effective prevention of POPF after distal pancreatectomy.
