Comparison of endostapler performance in challenging tissue applications

Area of Science:

• Surgical Technology
• Biomedical Engineering
• Gastrointestinal Surgery

Background:

• Surgical staplers are crucial for various procedures, requiring precise performance across diverse tissue types.
• Proper staple formation, specifically a B-shape, is vital for post-operative healing by ensuring adequate blood flow.
• Assessing staple formation in challenging tissues is essential for device development.

Purpose of the Study:

• To compare the staple formation performance of two different 60-mm linear endoscopic thick tissue reloads.
• To evaluate staple shape and malformation rates in varied porcine stomach tissue using varied-height stapler (VHS) and single-height stapler (SHS) reloads.

Main Methods:

• An ex vivo study utilizing porcine stomach tissue from 7 different regions.
• Two types of 60-mm linear endoscopic thick tissue reloads were tested: varied-height stapler (VHS) and single-height stapler (SHS).
• Staple formation was assessed for B-shape quality and malformation occurrence in each tissue region.

Main Results:

• The VHS reload achieved significantly better B-shaped staple formation across all tested stomach regions (P<.001).
• Malformed staples were reduced in 5 out of 7 regions when using the VHS reload compared to the SHS reload.
• The SHS reload showed comparable malformation rates in 2 of the 7 regions.

Conclusions:

• The varied-height stapler (VHS) reload offers superior staple formation outcomes compared to the single-height stapler (SHS) reload for thick tissue applications.
• VHS reloads are recommended for improved staple integrity and potentially better clinical healing outcomes.
• This study highlights the importance of reload design in achieving optimal staple formation in challenging surgical scenarios.