Article

Curved cutter stapler vs. linear stapler in rectal cancer surgery: A pilot prospective randomized study

Department of Surgery, Gil Medical Center, Gachon University of Medicine and Science, Incheon, Korea.
International Journal of Colorectal Disease (Impact Factor: 2.45). 08/2009; 24(11):1327-32. DOI: 10.1007/s00384-009-0771-6
Source: PubMed

ABSTRACT

This study aimed to compare the safety and technical accessibility of linear stapler and curved cutter stapler (CCS) during mid to low rectal cancer surgery.
Between April and November 2006, 60 patients were randomly assigned to either linear staplers (DST TA; United States Surgical, Tyco Healthcare Group LP, Norwalk, CT) or the CCS (Contour Curved Cutter Stapler(R); Ethicon Endo-Surgery, Inc., Cincinnati, OH) during low anterior resection for mid to low rectal cancers.
There were no significant differences in age, gender, body mass index, and mean carcinoembryonic antigen level between the two groups. Distal resection margin was longer in the CCS group as compared with the linear stapler group but did not reach statistical significance (24.7 vs. 20.8 mm, P = 0.065). There was no difference in the incidence of postoperative complications.
In this study, both the CCS and linear staplers were satisfactory devices for securing the distal rectum during low anterior resection in mid to low rectal cancers.

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    • "Therefore, a stapler device that allows good visibility, maneuverability and transection with the use of only one stapler firing would be preferable in low rectal surgery. The staplers for securing the distal rectum can be broken down into two categories: linear staples and curved cutter staplers [7]. The latter have the advantage that a knife is integrated in the device and that the curve allows deeper positioning in the pelvis. "
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    ABSTRACT: Introduction: Low rectal surgery remains challenging. New surgical stapler devices have been developed to counteract problems of impaired visibility and inability to get low into the pelvis. One of them is the Radial Reload (RR) with Tri-staple(™) Technology (Covidien, New Haven, CT, USA). The aim of this study was to assess the first impressions and experiences regarding handling of this new stapler device in low anterior resection procedures in living humans. Methods: A questionnaire, consisting of 27 statements concerning accessibility, maneuverability and visibility, was sent to 35 surgeons worldwide. Results: A total of 85 rectal surgical procedures, both open and laparoscopic, were assessed by 31 surgeons. In 97% of the procedures the surgeons agreed that the RR stapler device facilitated access in the low pelvis. The first stapler device firing achieved complete transection in 54% of the procedures. According to the surgeons' assessments, in 91% percent of the procedures the RR stapler device enabled creation of adequate margins. Visualization of the pelvic floor was reported in 93% of the procedures. In the surgeons' opinion, the RR stapler device was considered clinically acceptable in 93% of the procedures. In 79% of the procedures the surgeon preferred the RR stapler device over the stapler device they normally used. Conclusion: This study showed that the first experiences with the RR stapler device of 33 surgeons in 85 low rectal procedures are positive. It facilitates low stapling in both open and laparoscopic procedures. Good visibility, maneuverability and the possibility to create adequate distal margins were reported.
    Full-text · Article · Feb 2015 · International Journal of Surgery
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    • "At the Thoracic Surgery U.O.C. of San Paolo Hospital in Bari, Italy, the efficency of a new curved stapler for bronchial suturing was verified, comparing it to the linear staplers currently used. This stapler is characterized by similar features to the linear staplers and it had been only used (until our experience reported in this study) in rectal surgery [5] "
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