Staplers in digestive surgery: technological advancement in surgeons' own hands

Santo, Marco Aurélio; Takeda, Flávio Roberto; Sallum, Rubens Antônio Aissar

doi:10.1590/s0004-28032011000100001

Cited by 5 publications

(5 citation statements)

References 17 publications

(16 reference statements)

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“…However, conflict remains regarding which of the two methods of anastomosis gives better clinical results 2 . The evolvement of mechanical sutures by means of stapler use has become a realest technological advancement, as it has represented the concept of a new product with the combination of new functions that have resulted in improvements and effective gaining of quality or productivity in the handicraft suture process that has been done by surgeons for centuries 3 . Stapling instruments which is used in surgery were first presented in 1908 by Hültl, but they did not acquire popularity because they are expensive and untrusted.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study Between Stapler and Hand Sewing in Gastrointestinal Anastomosis

Maatooq¹,

Merdan²

2017

Basrah Journal of Surgery

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Gastrointestinal anastomosis is an important part of gastrointestinal operations and can be achieved by hand sewn anastomosis or by the newly developed staplers. The study aims to compare between the two surgical methods of anastomosis in a prospective , randomized design, regarding: operation time, post operative hospital stay and the incidence of post operative anastomotic leak in both groups. The study was carried out in Department of Surgery at Alsader Teaching Hospital in Basrah, Iraq from October 2015 to December 2016, it included 40 patients of both gender and with a different age, they divided into 2 groups (hand sewn and stapler groups), each group included 20 patients, comparing the following parameters: time of anastomosis, duration of surgery, post operative leak and hospital stay. There were no significant differences in the age, gender distribution, the indication for resection, post operative anastomotic leak (p=1) and hospital stay (P Value 0.15) in both group but there was significant differences in duration of anastomosis (P Value0 .00001) and operation time (P Value 0.00001). Our study concluded the superiority of stapler on hand sewing in gastrointestinal anastomosis in term of reducing operative time.

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Section: Introductionmentioning

confidence: 99%

Comparative Study Between Stapler and Hand Sewing in Gastrointestinal Anastomosis

Maatooq¹,

Merdan²

2017

Basrah Journal of Surgery

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“…It also decreases the anastomotic leak complication. 2 Stapler technique is now commonly used by many of the surgeons. It is more useful than the hand sewn anastomosis for safety, easily accessibility, shorter duration of procedure and efficiency.…”

Section: Introductionmentioning

confidence: 99%

Hand sewn versus stapler anastomosis in elective gastro intestinal surgeries

Banurekha¹,

Sadasivam²,

Sathyamoorthy³

2017

Int Surg J

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Background: The technique for intestinal anastomosis in elective gastrointestinal surgeries depends on site, bowel calibre and underlying disease. The decision to choose hand sewn or stapler anastomosis depends on surgical experience and preference. The objective of this study was to study the outcome of hand sewn anastomosis compared with stapler anastomosis in elective gastrointestinal surgeries.Methods: Retrospective comparative study was conducted in surgical wards of a tertiary referral hospital from July’2013 to June’2016. Data analysed with independent samples T-test to compare mean values between methods and Chi-square tests used to compare proportion of the two values.Results: Significant difference in duration of procedure, return of bowel sounds, starting of oral feeds, hospitalization days, return to work noted in stapler anastomosis compared with hand sewn anastomosis in subtotal gastrectomy and gastrojejunostomy. No difference in appearance of bowel sounds in right hemicolectomy and other resection and anastomoses group, no difference in return to work in right hemicolectomy group, no difference in starting of oral feeds in low anterior resection group. Other parameters were statistically significant in right hemicolectomy, low anterior resection and other resection and anastomosis groups. No significant difference observed in anastomotic leak between hand sewn and stapler methods. There was no mortality in stapler group.Conclusions: Stapler method significantly reduces duration of surgery, has early recovery with less mortality. Stapling is quick to perform in inaccessible situations like low colorectal anastomosis. Stapler anastomosis can be used safely and effectively in elective gastrointestinal surgeries.

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“…(2) The evolution of mechanical sutures by means of stapler use has become a real technological advancement , as it has represented the concept of a new product with the combination of new functions that have resulted in improvements and effective gains of quality or productivity in the handicraft suture process that has been done by surgeons for centuries. (3) Surgical stapling devices were first introduced by Hültl in 1908; however, they did not gain popularity because instruments were cumbersome and unreliable. The development of reliable, disposable instruments over the past 30 years has changed surgical practice dramatically.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Stapler Anastomosis Over Hand Sewn Anastomosis in Elective Gastrointestinal Surgeries

Nichkaode¹,

Kulshrestha²,

Akhtar³

et al. 2013

jemds

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Anastomosis in Gastrointestinal surgery is a very commonly performed procedure , since the era of Sushruta, various methods of intestinal anastomosis were followed-recent advancement is the use of stapler as a device for GI anastomosis. Because of the use of staplers technical failures is a rarity, anastomosis is more consistent, and can be used at difficult locations. MATERIALS AND METHODS: A total of 50 cases which met the inclusion and exclusion criteria were included in this hospital based prospective comparative study. The study population included all patients who underwent elective gastrointestinal surgeries. STUDY FACTORS: The subjects were allocated into two groups according to the type of anastomosis, hand sewn and stapler. Both hand sewn and stapled anastomosis were further divided into three sub-groups according to the site of anastomosis viz esophageal, gastrojejunal and colorectal. OUTCOME FACTORS: Anastomotic Integrity, Duration of operation, Return of Bowel activity, Hospital stay. RESULTS: A total of 50 patients with malignant or benign condition of bowel and esophagus, requiring anastomosis were allocated in study group of GI staplers and control group of conventional Hand sewn technique. Out of 50 cases there were 13 esophageal anastomosis, 19 gastrojejunostomies and 18 colorectal anastomosis CONCLUSION: In our present study, we found that stapling technique can significantly reduce the time for anastomotic procedure, less tissue trauma due to less tissue handling, there is early restoration of gastrointestinal function, early resumption of oral feeding and reduced duration of hospital stay which helps ultimately in early return to routine work, importantly staplers can be used at places were hand sewn anastomosis is technically difficult. Technique related complications do not show significant differences which suggests that one can use staplers with same safety and accuracy as sutures

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Staplers in digestive surgery: technological advancement in surgeons' own hands

Cited by 5 publications

References 17 publications

Comparative Study Between Stapler and Hand Sewing in Gastrointestinal Anastomosis

Comparative Study Between Stapler and Hand Sewing in Gastrointestinal Anastomosis

Hand sewn versus stapler anastomosis in elective gastro intestinal surgeries

Comparative Study of Stapler Anastomosis Over Hand Sewn Anastomosis in Elective Gastrointestinal Surgeries

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