Related Experiment Video
Updated: Mar 18, 2026
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
A Single Institution Review of Initial Application of a 5-mm Stapler
Andrew P Rogers1, Tiffany J Zens1, Jonathan E Kohler1
1Department of Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.
Background:
Operating in small spaces presents physical constraints that can be even more challenging in minimally invasive operations. Recently, a 5-mm stapler was approved for use in general surgery and pediatric surgery. Here, we present our initial experience using the 5-mm stapler in pediatric general surgery.
Materials And Methods:
A retrospective chart review was conducted to identify cases using the 5-mm stapler at our institution. Demographic data included age (in months) and weight (in kilograms). Operative data included indication for use, number of loads used, complications related to 5-mm stapler use, and interventions to address complications. A second review focused on patients undergoing the same operations, but using a 10-mm stapler.
Results:
A total of 60 staple loads were deployed in 32 procedures. There were four adverse outcomes, all recognized intraoperatively. One bleed resulted from application on irradiated tissue and another bleed from application to a small noninflamed mesoappendix. A bronchial staple line leak resulted from improper stapler loading, and a bowel anastomosis leak was oversewn with a single stitch. When compared with 32 matched cases using a 10-mm stapler, there was no difference in age (5-mm = 39.11 months, 10-mm = 50.21 months, P = .49) or weight (5-mm = 16.34 kg, 10-mm = 19.93 kg, P = .51). A total of 60 staple applications were used, with one bleed noted. There was no significant difference in overall complication rate (5-mm rate = 4/60, 10-mm rate = 1/60; P = .36).
Conclusion:
Our initial experience suggests that although there were more complications with the 5-mm stapler, there is no statistically significant difference in complication rates when compared with the 10-mm stapler. Furthermore, the 5-mm stapler complications can be corrected with device training and proper patient selection. In appropriately selected pediatric surgery cases with size limitations, the 5-mm stapler can be used to minimize the invasiveness of the operation.
Insights
The 5-mm stapler shows promise in pediatric general surgery, with initial data indicating no significant difference in complication rates compared to the 10-mm stapler. Proper training and patient selection are key for successful use.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Devices
Background:
- Operating in confined spaces poses challenges in minimally invasive procedures.
- A 5-mm stapler has recently been approved for general and pediatric surgery.
- This study reports initial experiences with the 5-mm stapler in pediatric general surgery.
Purpose of the Study:
- To evaluate the initial clinical experience and safety of a 5-mm stapler in pediatric general surgery.
- To compare the outcomes and complication rates of the 5-mm stapler with a 10-mm stapler in similar pediatric procedures.
Main Methods:
- Retrospective chart review of pediatric cases utilizing a 5-mm stapler.
- Data collected included patient demographics, operative details, and stapler-related complications.
- Comparison with a matched cohort of patients who underwent similar operations using a 10-mm stapler.
Main Results:
- 32 procedures involved 60 staple loads with the 5-mm stapler, resulting in four intraoperative adverse outcomes.
- Complications included bleeds and staple line leaks, with one bowel anastomosis leak requiring oversewing.
- No statistically significant difference in patient age, weight, or overall complication rates was observed when compared to the 10-mm stapler group.
Conclusions:
- Initial experience suggests the 5-mm stapler is a viable option for pediatric general surgery in size-limited cases.
- While complications occurred, they were manageable and not statistically different from the 10-mm stapler.
- Device training and careful patient selection can optimize the use of the 5-mm stapler to minimize invasiveness.
