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Due to the introduction of what are known as “end-to-end” devices, currently most gastrointestinal anastomoses can be performed safely.

One of the most important components of surgical staplers is the cartridges. Current advances in surgical staplers include three-line stepped loads that allow for graduated compression. Therefore, optimization of the interaction between the tissue and the stapler is achieved.

This kind of cartridge generates less stress on tissue during compression and clamping and allows for greater perfusion into the staple line, providing better performance irrespective of the tissue thicknesses.

When considering circular staplers, recent improvements in the design of the fixed anvil and the I-beam, combined with the three-line stepped cartridges, increase staple line strength and leakproofness when compared to other types of loads.

In this video, Dr. Lacy (Professor of Surgery and Head of Gastrointestinal Surgery Department, Hospital Clinic, Barcelona, Spain) explains the use of this three-line stepped circular stapler in the creation of the colorectal anastomosis during a laparoscopic anterior resection.


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Dr. Antonio M. de Lacy MD, PhD, FACS (Hon), FASCRS (Hon), IQL Director, Department of Surgery, Hospital Quirón Barcelona, Hospital Ruber Internacional Madrid and Clínica Rotger Palma de Mallorca; AIS Founder and President, Spain General Surgery
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