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Standard Precaution01:26

Standard Precaution

Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...

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Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
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Preventing a pitfall: no-knife staplers that require caution during handling.

Junichi Yoshida1, Koichi Furugaki

  • 1Shimonoseki City Central Hospital, Shimonoseki, Japan. yoshidaj@uicalumni.org

General Thoracic and Cardiovascular Surgery
|June 16, 2010
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The no-knife stapler aids pulmonary vessel division in video-assisted thoracoscopic surgery (VATS). Excessive articulation lever rotation can cause staple malformation, necessitating adherence to mobility limits for safe surgical practice.

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Area of Science:

  • Thoracic Surgery
  • Surgical Instrumentation
  • Minimally Invasive Procedures

Background:

  • Pulmonary vessel division is critical in VATS.
  • Ensuring staple integrity is vital for preventing complications.
  • No-knife staplers offer potential safety benefits.

Purpose of the Study:

  • To evaluate the safety and efficacy of a no-knife stapler for pulmonary vessel division in VATS.
  • To identify potential complications associated with the no-knife stapler.
  • To provide recommendations for optimal use of the device.

Main Methods:

  • Retrospective analysis of 177 VATS procedures using the NAW ENDOPATH Flex45 No Knife Endoscopic Linear Stapler.
  • Review of patient records for staple integrity and bleeding events.
  • Investigation into the cause of any observed staple malformations.

Main Results:

  • The no-knife stapler was used in 156 patients across 177 sessions.
  • Two instances of staple malformation were recorded.
  • These malformations did not result in any bleeding events.
  • Excessive rotation of the articulation lever was identified as the cause of malformation.

Conclusions:

  • The no-knife stapler is a potentially useful tool for pulmonary vessel division in VATS.
  • Adherence to the articulation lever's mobility limits is crucial to prevent staple malformation.
  • Proper technique ensures the safe application of this surgical stapler.