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Surgical staplers have been used for more than 100 years, making gastrointestinal transections and anastomosis safe, reliable, and enabling the fast and reproducible creation of anastomoses. However, complications such as stapler line dehiscence, which can be catastrophic for the patient, with similar consequences to the feared anastomotic leak, can also occur.
The characteristics of the staple are of utmost importance because its material should not spring back so as to keep the tissue compressed. Moreover, the surgeon must be aware of the optimal staple cartridge, given that undersizing cartridges can increase the risk of poor staple formation, while oversizing them can cause poor hemostasis and line dehiscence, and thus anastomotic leakage.
Surgical staplers are usually divided into linear and circular. Continuous advances are being made in staplers. One of the latest steps in the evolution of linear staplers has been their automation. Hence, automatic staplers can be regarded as "smart" staplers because they enable real-time feedback and powered rotation, articulation, and firing with one hand.
In this video, Dr. Lacy (Professor of Surgery and Head of Gastrointestinal Surgery Department, Hospital Clinic, Barcelona, Spain), explains the use of this linear stapler in the transection of the rectum during a laparoscopic anterior resection. After the specimen has been dissected in the pelvis, the rectum is transected with a Signia Linear Stapler purple cartridge.