The two-fire, one-cartridge stapling method using a modified Endo-GIA

The endoscopic stapler (Endo-GIA) was designed to divide tissue between two triple-stapled lines. The endoscopic surgeon frequently encounters situations where only stapling is required. Kirby described a staple closure method that uses a knifeless Endo-GIA cartridge. This method, although useful, has the problem of the modified Endo-GIA unit locking. Therefore, we devised a new technique for endoscopic stapling that involves two consecutive staplings using one cartridge without cutting. This method requires modification of the Endo-GIA system by removing the safety-lock system. In addition to enabling endoscopic stapling techniques without the risk of locking, the method can effect a significant cost savings.