Jan. 06, 2025
Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds or to resect and/or connect parts of an organ (e.g. bowels, stomach or lungs). The use of staples over sutures reduces the local inflammatory response, width of the wound, and time it takes to close a defect.[1]
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A more recent development, from the s, uses clips instead of staples for some applications; this does not require the staple to penetrate.[2]
The technique was pioneered by "father of surgical stapling", Hungarian surgeon Hümér Hültl.[3][4] Hultl's prototype stapler of weighed 8 pounds (3.6 kg), and required two hours to assemble and load.
The technology was refined in the s in the Soviet Union, allowing for the first commercially produced re-usable stapling devices for creation of bowel and anastomeses.[4] Mark M. Ravitch brought a sample of stapling device after attending a surgical conference in USSR, and introduced it to entrepreneur Leon C. Hirsch, who founded the United States Surgical Corporation in to manufacture surgical staplers under its Auto Suture brand.[5] Until the late s USSC had the market essentially to itself, but in Johnson & Johnson's Ethicon brand entered the market and today both are widely used, along with competitors from the Far East. USSC was bought by Tyco Healthcare in , which became Covidien on June 29, .
Safety and patency of mechanical (stapled) bowel anastomoses has been widely studied. It is generally the case in such studies that sutured anastomoses are either comparable or less prone to leakage.[6] It is possible that this is the result of recent advances in suture technology, along with increasingly risk-conscious surgical practice. Certainly modern synthetic sutures are more predictable and less prone to infection than catgut, silk and linen, which were the main suture materials used up to the s.
One key feature of intestinal staplers is that the edges of the stapler act as a haemostat, compressing the edges of the wound and closing blood vessels during the stapling process. Recent studies have shown that with current suturing techniques there is no significant difference in outcome between hand sutured and mechanical anastomoses (including clips), but mechanical anastomoses are significantly quicker to perform.[7][2]
In patients that are subjected to pulmonary resections where lung tissue is sealed with staplers, there is often postoperative air leakage.[8] Alternative techniques to seal lung tissue are currently investigated.[9]
The first commercial staplers were made of stainless steel with titanium staples loaded into reloadable staple cartridges.
Modern surgical staplers are either disposable and made of plastic, or reusable and made of stainless steel. Both types are generally loaded using disposable cartridges.
The staple line may be straight, curved or circular. Circular staplers are used for end-to-end anastomosis[broken anchor] after bowel resection or, somewhat more controversially, in esophagogastric surgery.[10] The instruments may be used in either open or laparoscopic surgery, different instruments are used for each application. Laparoscopic staplers are longer, thinner, and may be articulated to allow for access from a restricted number of trocar ports.
Some staplers incorporate a knife, to complete excision and anastomosis in a single operation. Staplers are used to close both internal and skin wounds. Skin staples are usually applied using a disposable stapler, and removed with a specialized staple remover. Staplers are also used in vertical banded gastroplasty surgery (popularly known as "stomach stapling").
While devices for circular end-to-end anastomosis of digestive tract are widely used, in spite of intensive research [11][12][13][14][15] circular staplers for vascular anastomosis never had yet significant impact on standard hand (Carrel) suture technique. Apart from the different modality of coupling of vascular (everted) in respect to digestive (inverted) stumps, the main basic reason could be that, particularly for small vessels, the manuality and precision required just for positioning on vascular stumps and actioning any device cannot be significantly inferior to that required to carry out the standard hand suture, then making of little utility the use of any device. An exception to that however could be organ transplantation where these two phases, i.e.device positioning at the vascular stumps and device actioning, can be carried out in different time, by different surgical team, in safe conditions when the time required does not influence donor organ preservation, i.e. at the back table in cold ischemia condition for the donor organ and after native organ removal in the recipient. This is finalized to make as brief as possible the donor organ dangerous warm ischemia phase that can be contained in the couple of minutes or less necessary just to connect the device's ends and actioning the stapler.
Although most surgical staples are made of titanium, stainless steel is more often used in some skin staples and clips. Titanium produces less reaction with the immune system and, being non-ferrous, does not interfere significantly with MRI scanners, although some imaging artifacts may result. Synthetic absorbable (bioabsorbable) staples are also now becoming available, based on polyglycolic acid, as with many synthetic absorbable sutures.
Where skin staples are used to seal a skin wound it will be necessary to remove the staples after an appropriate healing period, usually between 5 and 10 days, depending on the location of the wound and other factors. The skin staple remover is a small manual device which consists of a shoe or plate that is sufficiently narrow and thin to insert under the skin staple. The active part is a small vertical blade that, when hand-pressure is exerted, pushes the staple down through a slot in the shoe, deforming the staple open into an 'M' shape to facilitate its removal. In an emergency, it is also possible to remove staples with a pair of artery forceps.[16] Skin staple removers are manufactured in many shapes and forms, some disposable and some reusable.
Surgical staplers are specialized staplers used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs. The use of staples over sutures reduces the local inflammatory response, width of the wound, and the time it takes to close. In this blog post, we will explore the functionality and versatility of a particular stapler designed to meet precise requirements ' the disposable circular stapler.
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Disposable circular staplers are unique devices that are primarily used in the medical field, specifically in surgical procedures. Circular staplers are used mainly for end-to-end and end-to-side anastomoses of the esophagus, stomach, and rectum. These staplers work on the principle of circular compression, allowing surgeons to create secure connections between tissues during surgery.
Unlike traditional staplers, disposable circular staplers are designed for single-use only. This ensures that each patient receives a sterile stapler, reducing the risk of infection or cross-contamination. Typically, these staplers are made from medical-grade materials and feature a cartridge body, a cutting knife and an anvil.
Disposable circular stapler finds extensive use in gastrointestinal surgeries like gastric bypass, colon resection, and rectal prolapse repair. These procedures often involve connecting or dividing different parts of the intestine, and the circular staplers enable surgeons to create secure anastomosis or connections within the digestive tract.
In anorectal surgeries, disposable circular staplers assist in performing procedures like hemorrhoidectomy and anal fistula repair. By efficiently dividing and reconnecting damaged tissues, these staplers help reduce surgical time and optimize patient outcomes. The circular stapler's unique mechanism ensures precise closures, minimizing the risk of post-operative complications.
Disposable circular staplers are also utilized in thoracic and abdominal surgeries, particularly for lung and colorectal procedures. By creating efficient, leak-proof anastomotic connections between the organs, surgeons can ensure the integrity of the tissue being operated on while minimizing the risk of leaks or post-operative complications.
Precise and Reliable
Disposable circular staplers are renowned for their precision and reliability, providing surgeons with confidence during delicate procedures.
Time-Saving
The circular stapler's mechanism enables faster connections, reducing surgical time and improving patient outcomes.
Reduced Risk of Infection
With the disposable nature of circular staplers, the risk of infection or cross-contamination is significantly minimized.
Enhanced Healing and Recovery
By minimizing tissue trauma during surgery, disposable circular staplers contribute to better post-operative healing and patient recovery.
Disposable circular staplers have revolutionized surgical procedures, providing surgeons with a versatile and reliable tool that simplifies and streamlines various medical interventions. From gastrointestinal surgery to anorectal and thoracic procedures, these staplers offer precision and speed, contributing to improved patient outcomes. With their disposable nature, the risk of infection is significantly reduced, adding another layer of safety to surgical procedures. If you're a medical professional involved in these specialties, considering disposable circular staplers is a worthwhile investment.
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