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At least 199 records · Page 11Linked to original sources
PubMed1991

Automatic stapling devices in the surgical treatment of esophageal diverticula.

Experience is presented of 18 patients in whom surgical treatment of esophageal diverticulum included use of an automatic stapling device. Ten diverticula were pharyngoesophageal, three mid-esophageal and five epiphrenic. One-stage diverticulectomy with myotomy was performed in all cases. Postoperative follow-up was 6-66 months. The results were excellent, without early or late complications or recurrence.

Diverticulum, Esophageal↗
PubMed1990

[Power staple implantation--progress in the surgical technique of bone fixation].

Fixation with staples, which are driven into the bone by a special air-driven gun, provides a technical improvement over a hand-held device. Correct handling of the staple gun gives exact seating and placement into bone. Since January 1, 1988, this method has been used in 43 patients with good results and few complications.

Adult↗
PubMedDate not supplied

[Mechanical digestive system suturing devices].

Between 1994 (December)-1996 (May) 150 patients have been operated on using one or many stapling devices. The staplers disposable to us were the "Linear Cutter" or GIA (Gastrointestinal Anastomosis), "Linear Stapler" (TA) and "Intraluminal Circular Stapler" or EEA (end-to-end anastomosis) types, produced by ETHICON (Johnson and Johnson Ltd. Company). The principles operations performed were various digestive resections, intervisceralis anastomosis and interventions of reconstructions (in oesophagus surgery, ileal pouch etc.). The advantages of staplers applications are: a) the reduction of the time of operation, of the anesthesia, of the blood loss; b) a soft manipulation of the tissues; c) a smaller inflammatory reaction and the prevention of intraoperative septic contamination and d) a better and faster take back of the functionality of the anastomosis. There were only 4 intraoperative haemorrhages easy controllable. Postoperative complications: a) 3 haemorrhages medically treated; b) immediate leakage 1 patient after colorectoanastomosis, treated by Hartman colostomy; precocious, 7 patients and after 4-6 month, 2 patients. Corrective iterative interventions were necessary only in 5 patients. The operative mortality-1 patient, the cause of death being a bronhopneumonia after a radical oesophagectomy with oesophagoplasty (oesophageal cancer). There was not postoperative mortality depending of stapling application. We don't observed late postoperative complications like stenosis of various anastomosis, quoted in the literature, because the time of following of our 150 patients is too short (maximum 18 months). The conclusions are that the stapling devices are a real surgical progress with the conditions of a correct indication and adequate tactics and operative technique. The economical effort is justified and entirely compensated by the major benefits obtained for the patients.

Anastomosis, Surgical↗
PubMed1999

Stapled functional end-to-end anastomosis in Crohn's disease.

The aim of this study was to review our experience of stapled functional end-to-end anastomosis following a bowel resection for Crohn's disease. Between 1988 and 1997, 62 patients underwent 63 stapled functional end-to-end anastomoses, including 54 ileocolonic, 8 ileoileal, and 1 colocolonic. One patient developed an anastomotic leak and required a laparotomy. There were no anastomotic complications in any other patients. The median duration of follow-up was 21 (rang: 4-122) months. Only one patient developed recurrence at the stapled ileocolonic anastomosis 35 months after the operation. However, this patient required no further surgical treatment. Stapled functional end-to-end anastomosis is associated with a low incidence of complications and a low incidence of early recurrence. This technique may therefore be the anastomotic configuration of choice following a bowel resection for Crohn's disease.

Adult↗
PubMed2000

Long-term results after low anterior stapled anastomosis.

In the period 01.01.1991-12.31.1996, 286 low anterior stapled resections of the rectum due to rectal carcinoma were performed at the First Surgical Clinic, the Third Department for Colorectal Surgery, Belgrade. There were 57% males and 43% females, median age 59.6 years. The most common localization of tumor was in the distal third of the rectum 181 (63%). In the middle third, there were 89 (31%) and in the upper, intraperitoneal third 16 (6%). Histopathological examination revealed adenocarcinoma in all cases. All operative specimens were examined by one pathologist and classified according to the Gunderson-Sosin modification of Dukes classification. There were 14 (4.9%) in stage A, 167 (58.4%) in stage B (B1,B2,B3), 89 (31.1%) stage C (C1,C2,C3) and 16 (5.6%) stage D. According to Broders classification, there were 129 (45%) well differentiated, 142 (50%) moderately and 15 (5%) poorly differentiated tumors. Anastomotic dehiscence was found in 17 patients (5.95%), mostly conservatively treated, except in 6 cases where spreading peritonitis developed requiring operative treatment. There were 9 (3.1%) postoperative deaths, a half of them with specifically operation related mortality. Recurrence of the disease was registered in 47 (18%) patients, out of 260 who were regularly followed up (26 were lost). Local recurrence alone was found in 21 (8.0%) patients, while distant spread was registered in 22 (8.46%) patients. Local and distant spread was found in 4 (1.5%) cases. At present, the median follow-up is at 54 months. Analysis by the Kaplan-Meier's test shows cumulative survival of 66% at 71 months of the follow-up. Seventy four percent of patients with curative operations exhibit no signs of recurrence at 5 years.

Adenocarcinoma↗
PubMed1995

Disruption of a stapled anastomosis following therapeutic ultrasonics--is there a risk? Report of a case.

PURPOSE: We examined the theoretic possibility that therapeutic ultrasound can disrupt a stapled gastrointestinal anastomosis. METHOD: A case is reported in which leakage of a stapled ileocolic anastomosis occurred following therapeutic ultrasound. Calculations are performed on the power of the ultrasound beam and its adsorption and dispersion in the tissue between the probe and anastomosis to establish its intensity at the anastomosis. RESULTS: Ultrasound intensity at the anastomosis in this patient was calculated at 10 to 46 mW/cm2. CONCLUSION: Although the calculated ultrasound intensities at the anastomosis do not appear to be very high, other factors such as "pressure doubling" and "stress concentration" at the stapled surface suggest that therapeutic ultrasound may cause staple disruption.

Anastomosis, Surgical↗
PubMed2000

Radical cystectomy: minimizing operative blood loss with a "stapling technique".

We describe our experience with a surgical technique using the multiple fire Endo-GIA-30-3.5 stapler to control the vascular pedicles during radical cystectomy. This technique was performed in 16 radical cystectomies, including three pelvic anterior exenterations for female invasive bladder carcinoma, and compared with 23 cases treated with the conventional method. It was associated with a significant decrease in the intraoperative and postoperative blood loss and a shorter operative time.

Blood Loss, Surgical↗
PubMed2003

[Surgery of hemorrhoids using the Long method and its complications].

BACKGROUND: The aim of this article is an assessment of new surgical procedure--stapled hemorroidectomy according to Longo. We do concentrate on surgical complications and possibilities of it's management. METHODS: Prospective, clinical follow up of patients in which stapled hemorrhoidectomy was performed during the period of 2 years (1st December 2000--30st November 2002). Observation concentrates on surgical complications of this method. All patients had a clinical check up 3 weeks and 3 months after surgery. In case of any problems treatment and follow up continues. RESULTS: Stapled hemorroidectomy was performed during the period of 2 years in 52 patients (100%). There was 11 patients (21.2%) with some of surgical complication. The most serious one was massive rectal bleeding after surgery, which has been observed in 4 patients (7.6%). Other surgical complications observed in our group were anal stenosis, local infection, acute anal fissure and retention of urine. CONCLUSION: Stapled hemorroidectomy is now one of feasible alternatives for surgical treatment of hemorrhoids. Serious surgical complications observed in our patients were bleeding from the stapled suture line and anal stenosis. The aim of this article is to refer possible surgical complications of this method, it's prevention and management.

Adult↗
PubMed2006

Functional comparison of staple line reinforcements in lung resection.

PURPOSE: Staple line reinforcement with bovine pericardium and expanded polytetrafluoroethylene during lung resections has shown reduction in air leak incidence and duration. Small intestinal submucosa and polyglycolic acid-trimethylene carbonate, have been introduced as new reinforcements for nonpulmonary staple lines. We hypothesize that reinforcement of staple lines in lungs with commercially available materials will decrease staple line leak at increased pressures. DESCRIPTION: We evaluated 8 staple lines per reinforcement material (4 groups) and a control group (n = 40) in healthy living pigs. After resections (up to four per animal), the lungs were tested sequentially using hand ventilation to increasing pressures (5-75 cm H2O). The occurrence of pressure at which leaks was recorded. EVALUATION: All reinforced staple lines exhibited higher mean leak threshold when compared with the controls; however only small intestinal submucosa achieved significance when compared with the controls. CONCLUSIONS: Commercially available reinforcements allow pulmonary staple lines to tolerate higher intrabronchial pressures without demonstrating air leak. In addition, reinforcement with small intestinal submucosa imparts a significant advantage to the other reinforcements in terms of pulmonary staple line leak rate.

Anastomosis, Surgical↗
PubMed2004

Staple-line reinforcement techniques with different buttressing materials used for laparoscopic gastrointestinal surgery: a new strategy to diminish perioperative complications.

Many techniques have been analysed to reduce the risk of perioperative anastomotic leakage and bleeding. No specific resection technique with either linear or circular stapling devices has been shown to be superior in preventing these complications. Reinforcement of staple lines with various buttressing materials is a new strategy used to diminish or eliminate anastomotic leaks and haemorrhage. In this chapter, varying reinforcement techniques with different materials are compared. The available literature has been reviewed thoroughly for relevant data regarding stapled reinforcement techniques and minimizing anastomotic leaks and haemorrhage. Reported data show non-absorbable, semi-absorbable, and bioabsorbablematerials available for gastrointestinal (GI) resections. Semi-absorbable xenomaterials (Bovine Pericardial Strips and Bovine Collagen Strips; Shellhigh No-Reaction Vascupatch, Milburn, NJ, USA), non-absorbable expanded polytetrafluoroethylene (ePTFE; W.L. Gore, Elkton, MD, USA) and absorbable poly (L-lactic acid-co-epsilon-caprolactomne) film are compared. Non-absorbable and semi-absorbable materials show many differences. Absorbable polymer membranes demonstrate marked benefits. Staple-line reinforcement used for laparoscopic GI surgery is a relatively new strategy, most probably improving perioperative outcome only if proper buttressing material is used. To decrease anastomotic complications, using an absorbable polymer membrane as staple-line reinforcement material is reliable and efficacious.

Biocompatible Materials↗
PubMed1995

Comparison of manually constructed and stapled anastomoses in colorectal surgery. West of Scotland and Highland Anastomosis Study Group.

OBJECTIVE: The authors compared both the initial and the long-term outcomes of patients undergoing stapled and sutured colorectal anastomoses. SUMMARY BACKGROUND DATA: Sutured and stapled large bowel anastomoses are perceived to be equally safe, but concern has been raised about increased rates of tumor recurrence with the use of stapling instruments. METHODS: The outcome of patients with sutured and stapled colorectal anastomoses were compared in a prospective, multicenter, randomized study. Factors affecting long-term outcomes were assessed by both univariate and multivariate analysis. RESULTS: Seven hundred thirty-two patients were recruited. There was a significant increase in radiologic leakage in the sutured group (14.4% vs. 5.2%, p < 0.05), but there was no difference in clinical anastomotic leak rates, morbidity, or postoperative mortality. Tumor recurrence and cancer-specific mortality were higher in the sutured patients (7.5% and 6.7%, respectively) and in patients with anastomotic leaks. CONCLUSIONS: This study shows that suturing or stapling are equally safe in large bowel surgery. However, it also shows a long-term benefit of stapling in colorectal cancer patients.

Anastomosis, Surgical↗