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At least 55 records · Page 3Linked to original sources

The autosuture surgical stapling instruments: preliminary experience.

Stapling instruments for gastrointestinal surgery are relatively new in the surgical armamentarium of Australian surgeons. In an attempt to assess their safety and handling characteristics laboratory experience has been obtained in dogs. This has shown that these instruments are effective and easily handled, although costly in routine use. It seems likely that they will provide an appropriate alternative to certain conventional anastomotic techniques.

Animals↗

Surgical staples in cesarean section: a randomized controlled trial.

This randomized controlled trial compares the use of the Auto Suture Poly CS 57 disposable surgical stapler (n = 98) with standard hysterectomy (n = 102) in low transverse cesarean sections. Subjective assessment of blood loss by the surgeon resulted in lower mean (+/- SEM) total blood loss estimates in the stapled group (492 +/- 24 ml) than in the nonstapled group (579 +/- 38 ml) (p = 0.05). However, surgeon's estimation of blood loss as a result of the hysterotomy and blood loss estimated by the hemoglobin deficit measured on the second postoperative day did not significantly differ between the two groups. The use of the stapling device tended to lengthen the total operating time, which averaged 42.5 minutes in the group with the staples and 39.2 minutes in the group with the standard hysterotomy (p = 0.05). The risk of febrile morbidity, the frequency of endometritis, and the length of hospitalization were similar in the two groups. Our results do not support the routine use of the Auto Suture Poly CS 57 disposable surgical stapler in low transverse cesarean sections.

Adult↗

Development of the surgical stapling device.

Most surgeons who use staplers today attribute their invention to researchers who worked during the mid-fifties in the Soviet Union. While the modern staplers are derivates of those instruments, it also needs to be emphasized that they were preceded by stapling devices which were used extensively as early as the first decade of this century. The early history of surgical staplers is full of imaginative new ideas and technical solutions clearly identified as the instruments we use today were developed. The great men in Hungary and Germany who invented the early staplers should be remembered for their accomplishments.

Germany↗

Ligature versus purse string for surgical stapled anastomoses.

Intraluminal circular stapling in gastrointestinal surgery requires a purse string suture which secures the bowel around the anvil of the head of the stapling gun before firing. An alternative method of securing the bowel around the anvil is described.

Anastomosis, Surgical↗

Bronchopleural fistulas after pneumonectomy. A problem with surgical stapling.

After multiple reports demonstrating excellent results and improved healing of the bronchial stump in cases of pneumonectomy performed with standard reusable parallel firing stapling devices, there has been an isolated report from Europe of increased incidence of bronchopleural fistulas with the use of the modified reusable hinged stapling device. Our report confirms and extends that observation. Review of 42 successive pneumonectomies revealed one case of bronchopleural fistula with the use of the standard reusable parallel firing stapling device; there were six cases of bronchopleural fistulas in 36 successive pneumonectomies performed with the modified hinged stapling device (four with reusable and two with disposable instruments). Improperly formed staples were identified by x-ray examination or reoperation. We recommend that only the standard reusable parallel firing stapling devices be used for bronchial closure in pneumonectomy.

Bronchial Fistula↗

Intestinal anastomoses after radiation therapy by surgical stapling instruments.

The use of automated stapling instruments in 17 patients requiring intestinal surgery following irradiation therapy for gynecologic malignancies has been reviewed. Fifteen of these patients also had other medical problems thought to inhibit optimal anastomotic healing: malnutrition, persistent intraabdominal cancer, uremia, hypoalbuminemia, and recent antineoplastic chemotherapy. Although these conditions severely test a method of intestinal anastomosis, no patient had a complication involving the intestinal anastomosis. The use of these stapling instruments reduced both the operating time and the contamination of the peritoneal surfaces by bowel content, thereby improving the postoperative recovery of these patients. The favorable results and the secure anastomoses justify the continued use of stapling instruments in gynecologic oncology patients with prior irradiation therapy.

Female↗

Esophagogastrectomy using the auto suture EEA surgical stapling instrument.

A stapling instrument, which creates end-to-end inverting anastomoses, is described for esophagogastrostomy. The inverted anastomosis is held together by a double staggered row of stainless-steel wire staples. Experience with 7 consecutive patients who underwent esophagogastrectomy for carcinoma of the distal esophagus or proximal stomach using this device is reported. Postoperative complications included atelectasis in 1 patient, cardiac failure in 1, and pneumonia in 1. A fibrotic stricture developed at the anastomotic site 5 months postoperatively in 1 patient. There were no anastomotic leaks. The stapled anastomosis takes 2 to 3 minutes to perform and seems to be at least comparable to handsewn anastomoses.

Adenocarcinoma↗

Experience with auto suture surgical stapling instruments. Fate of enterically applied staples.

Inverting serosa-to serosa staple applications may lead to intraluminal extrusion of staples. The possible clinical pathological consequences of such a migration are examined. Technical maneuvers designed to prevent errors and expedite safer handling of automatic stapling devices are presented. Automatic stapling instruments, both in the animal model and in the clinical situation, have produced eminently satisfactory results for us.

Animals↗