Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Surgical Stapling”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed1996

Selective preservation of the anal transition zone in ileoanal pouch procedures.

PURPOSE: A prospective trial was conducted to evaluate use of certain preoperative criteria in the choice of operative technique for ileal pouch-anal anastomosis (IPAA). Handsewn vs. stapled anastomotic techniques were compared as was preservation vs. excision of the anal transition zone (ATZ). METHODS: Over an 18-month period, 40 consecutive patients underwent restorative proctocolectomy with IPAA for ulcerative colitis (31 cases) or familial adenomatous polyposis (9 cases). In 28 patients, ATZ was completely excised, by either a transanal mucosectomy with handsewn anastomosis (Group I, 13 cases) or by double-stapled technique (Group II, 15 cases). The ATZ was preserved and the anastomosis was double-stapled in colitis patients with suboptimum sphincter function and/or greater than 50 years of age in the absence of dysplasia or severe distal proctitis (Group III, 12 cases). RESULTS: Groups I and II patients were homogeneous in their preoperative variables and had equivalent functional outcome. Group III patients were older (P = 0.0001), with weaker preoperative anal sphincter resting tone (P = 0.024). Compared with Groups I and II, patients in Group III had significantly greater 24-hour stool frequency (P = 0.0056), daytime stool frequency (P = 0.0125), and incidence of daytime fecal seepage (P = 0.007). There was no significant difference in other outcome variables in Group III patients. There was no difference in morbidity in the three groups. CONCLUSIONS: Transanal mucosectomy with handsewn anastomosis provided early functional results equivalent to low anal transection with double-stapled IPAA in younger patients with excellent preoperative sphincter function. A double-stapled technique with preservation of the ATZ may be reserved for older patients, with poorer anal sphincter function, at minimum dysplasia/cancer risk, to optimize continence figures.

Adenomatous Polyposis Coli↗
PubMed2005

Stapled hemorrhoidectomy under local anesthesia: tips and tricks.

Stapled hemorrhoidectomy--a new, evolving technique--is considered to be safe and painless. General and spinal anesthesia are the "gold standard" anesthetic techniques for the procedure. The stapled hemorrhoidectomy under local anesthesia is described. Emphasis is given in few tips and tricks for safe and successful application of the local anesthesia.

Adult↗
PubMed2005

Meniscal repair using the Polysorb Meniscal Stapler XLS.

We present our technique of repair of meniscal tears in 11 patients using a newly designed stapler, the Polysorb Meniscal Stapler XLS (USS Sports Medicine, Norwalk, CT), to increase the effectiveness and ease of repair of tears in the vascular zone while limiting potential complications. The low-profile stapler comes with a reloadable pistol grip device and a disposable straight or 15 degrees upcurved shaft with a single preloaded 10-mm staple. Standard anteromedial and anterolateral portals were used, along with a superomedial portal for inflow. The portal was enlarged slightly to facilitate introduction of the cannula or the stapler directly into the knee. The nose of the stapler was applied to the superior surface of the inner edge of the meniscal tear. The sharp points on the tip of the nose were used to manipulate the inner edge and coapt the tear site. Firm pressure was applied to the meniscal tissue, and the nose of the stapler was embedded in the inner edge of the meniscus no more than 2 to 3 mm from the tear (as measured along the meniscal surface). The handle was pulled slowly as the staple engaged the meniscal tissue. This step was repeated every 3 to 4 mm to ensure ideal tear stabilization.

Adolescent↗
PubMedDate not supplied

Teflon buttress inhibits recanalization of uncut stapled bowel.

The uncut Roux limb operation is designed to have the benefits of a Roux limb but still have electrical continuity from proximal to distal bowel, thus eliminating the risk of Roux stasis syndrome. The main complication has been recanalization of the uncut staple line leading to bile reflux. This study aims to employ a new technique, which will not allow recanalization of an uncut staple line but will not interfere with normal bowel myoelectric activity. Fourteen mongrel dogs, 25 to 35 kg, underwent a midline laparotomy under general anesthesia. An uncut staple line was placed 25 cm from the ligament of Treitz. In seven animals an uncut staple line alone was placed, and in the other seven animals the bowel was stapled between a sandwich of Teflon reinforcing strips such that the staples were held on both sides of the bowel by the Teflon. A jejunojejunostomy was placed 6 cm proximal to the staple line. Insulated bipolar electrical leads were placed around the staple line. After the electrical leads were monitored 2 days to 3 months postoperatively for bowel myoelectric activity, The animals were killed and the operative sites inspected. No animal suffered morbidity or mortality from the procedure. All seven unreinforced staple lines recanalized and all seven reinforced staple lines remained competent. The duodenal pacemaker potentials were transmitted through the staple line in five animals (3 controls and 2 with Teflon reinforcement) with in 1 week postoperatively. The uncut staple line does not reliably transmit the duodenal pacemaker potentials. The staple line does not recanalize when it is reinforced with a permanent material, increasing the utility of the "uncut" Roux limb operation.

Action Potentials↗
PubMed1995

A prospective randomized trial of absorbable staple fixation of skin grafts for burn wound coverage.

A prospective randomized trial of absorbable versus metal skin staples for securing skin grafts to excised burn wounds was performed in 20 patients. The absorbable staples were easy to use and efficacious in securing the skin grafts, except to edematous fatty tissue. Aesthetically, the absorbable staples yielded as good or better results when compared with metal staples resulting from a lack of tissue distortion. A decrease of 61.4 minutes of the most significantly painful portion of the postoperative dressing change (i.e., staple removal) would have been avoided by using absorbable staples. The overall cost of using the absorbable staples for small burns was comparable with metal staples; however, the cost difference was significantly greater for large burns.

Adult↗
PubMed2002

Rectal cancer as a complication of stapled IPAA.

A case of rectal cancer developing several years after a stapled pelvic pouch procedure is described. The need for concern about leaving residual columnar epithelium in patients with dysplasia or a synchronous cancer is highlighted. In this setting, leaving long segments of native rectum is particularly ill advised.

Adenocarcinoma, Mucinous↗
PubMed1998

The reliability and validity of an instrumented staple system for in vivo measurement of local bone deformation. An in vitro study.

We recently presented a pilot study using an instrumented staple system for measuring in vivo local deformation on tibia. Methodological development has now proceeded in vitro. Consecutively, we performed 1. a sheep bone micrometer study, 2. a sheep bone four-point bending test and 3. a pig bone four-point and three-point bending test. This was done in order to secure a standardized application of the staple, to analyze the interaction of the bone and the staple and to secure calibration and the reliability of the system to be used in vivo. With reference to the above studies: 1. There was a linear relationship (r = 0.998) between the applied deformation of the bone and the measured deformation of the staple. ICC values ranged from 0.866 to 0.997. 2. An excellent intra-test reliability as well as linearity between staple measures and surface strain on the bone was observed (r = 0.998). 3. The slope of regression lines (k) was min 7.2 and max 9.4. The results from this test are used for calibration of the instrumented staple. Great variations were found between tension and compression measurements. However, within each test the SD was negligible. We suggest that the instrumented staple system may be calibrated in vitro and validly used for in vivo measurement of local bone deformation.

Animals↗
PubMedDate not supplied

Treatment of esophagojejunostomic leakage by cervical stapling and loop jejunostomy.

Reestablishment of digestive continuity after radical surgery for severe esophagojejunostomic leakage is a major challenge associated with high morbidity and uncertain feasibility. In this case report we describe a conservative double exclusion technique involving cervical stapling and loop jejunostomy. This technique greatly simplifies subsequent reconstruction and is suitable in most cases.

Adenocarcinoma↗
PubMed1996

[Selection of staple for closure of the lobar bronchus].

From January 1984 to October 1995, Stapling of lobar bronchus excluding middle lobe was investigated in 335 patients with lung cancer. We used routinely the 3.5 mm staple in the previous term and the 4.8 mm staple in the latter term. The stapling with 3.5 mm staple was performed in 220 patients. The stapling failed in the pressure proof test intraoperatively in 8 patients and bronchopleural fistula occurred postoperatively in 4 patients. The bronchus was cut or destroyed by the staple in most of them. The stapling with 4.8 mm staple was performed in 115 patients. The stapling failed in the pressure proof test intraoperatively in one patient because of loose closure of the bronchus. Bronchopleural fistula did not occur postoperatively. In conclusion, the 4.8 mm staple is a better choice for closure of the lobar bronchus except for a small woman or middle lobe.

Adult↗
PubMed1997

Results of the double stapling procedure in colorectal surgery.

In this report we review our results with the double stapling technique (DST) in 162 patients with colorectal diseases in an attempt to identify some of the potential pitfalls of this new technique. Among these 162 patients, there were 125 patients with colorectal cancer, 25 with chronic ulcerative colitis (UC), 9 with familial adenomatous polyposis (FAP), 2 with adult Hirschsprung's disease, and 1 with sigmoid colon fistula. A total of 46 anastomoses (28 for rectal cancer, 13 for UC, 3 for FAP, and 2 for adult Hirschsprung's disease) were performed at or near the dentate line. Of these, 10 had protective diverting colostomy or ileostomy. The results showed that 6 patients with rectal cancer had anastomotic leakage (3.7%); however, 4 of the 6 patients had also received preoperative irradiation. All the leaks healed after the patients had undergone diverting colostomy, but 7 patients with rectal cancer suffered from neurogenic bladder postoperatively (4.3%). Wound infection occurred in 4 patients (2.5%), anastomotic bleeding in 3 (1.9%), and anal pain in 1 (0.6%), respectively. One patient with rectal cancer and multiple liver metastases died of disseminated intravascular coagulation (DIC). These results thus suggest that the double stapling technique provides a safe anastomosis at or near the dentate line not only for rectal cancer but also for UC, FAP, and adult Hirschsprung's disease.

Adenomatous Polyposis Coli↗
PubMed1997

Meniscal fixation with an absorbable staple. An experimental study in dogs.

An absorbable staple for meniscal fixation was developed and evaluated in an in vivo canine study. The staple consisted of two rigid barbed legs, made of a copolymer of polyglycolic acid and polylactic acid, connected by a flexible suture made of the same absorbable material. The staple was developed for arthroscopic use, eliminating the risk of nerve or vascular injuries associated with suture fixation. Eighty-two mongrel dogs underwent meniscal repair in this study, which was performed in two sequential parts. An incision was made in the medial meniscus at the peripheral third and was fixed with either the staple or with a single 3-0 PDS suture. The animals from the first part of the study, in which the biocompatibility of a prototype staple design, was evaluated were sacrificed at 3 days, 2 weeks, 6 weeks, 3 months, and 9 months. Those from the second part of the study, in which an improved staple design of the same material, was evaluated were sacrificed at 6 weeks, 4 months, and 1 year. The operated menisci were either examined histologically or were mechanically tested for tensile strength. Absorption of the staple began by 3 months and was almost complete by 1 year. Mechanically, the staple provided greater tensile strength augmentation of the meniscus than suture fixation for up to 4 months. In the long term, there was no difference between the staple and suture in enhancement of healing.

Analysis of Variance↗
PubMed2006

Low hemorrhoidopexy staple line does not improve results and increases risk for incontinence.

BACKGROUND: The ability of stapled hemorrhoidopexy (SH) to cure hemorrhoidal symptoms appears to depend on patient characteristics and operative technique. We assessed the association between outcome of SH and patients' characteristics and procedure parameters (associated procedure, suture line height, doughnut size, presence of malpighian tissue or smooth muscle in specimen). METHODS: A total of 68 consecutive patients (56 males) were prospectively operated by 3 different surgeons. Hemorrhoids were grade II (6%), grade III (76%) or grade IV (18%). RESULTS: At a mean 32-week follow-up (range, 9-77), symptoms had resolved in 77% of patients, independently of any operative or clinical parameter. New onset anal incontinence occurred in 11 men (17%): all had urgency, with flatus and liquid stool incontinence in two, and flatus incontinence and mucus soiling in one. Univariate analysis revealed that persistent incontinence was associated with a staple line <6.5 mm from the dentate line, doughnut height <22 mm, and congestive external hemorrhoids; it was also operator dependent (p<0.05). At the 4-week follow-up, 19% of patients had persisting symptoms but only 8% had a demonstrable mucosal prolapse. CONCLUSION: Although the success rate of SH may not be influenced by technical variations, risk for moderate incontinence is elevated when the stapled line is low.

Adult↗
PubMed1994

Rapid construction of right colon pouch: initial clinical experience.

Between December 1992 and July 1993, 7 patients who underwent urinary diversion after cystectomy or bladder augmentation had colon pouches constructed with an "absorbable" staple. Our "one-step" technique of colon pouch construction incorporates standard principles of bowel detubularization and refashioning using absorbable GIA staples. The technique is easily learned and decreases operative time and blood loss. Herein we report follow-up of the first 7 patients undergoing this modification.

Adolescent↗
PubMed1998

The role of endoscopic stapling diverticulotomy in recurrent pharyngeal pouch.

Endoscopic stapling diverticulotomy is an increasingly popular treatment option for pharyngeal pouch. It has been our treatment of choice for the condition for over three years. Of the over 50 cases treated using the technique, three were performed for recurrent pouches--two following previous endoscopic stapling diverticulotomy and one following previous external excision. We describe these three cases to highlight the advantages and effectiveness of the technique in recurrence cases.

Aged↗
PubMed2003

Iliac artery pseudoaneurysm as a complication of laparoscopic rectopexy.

The occurrence of arterial pseudoaneurysms after laparoscopic cholecystectomy in the right hepatic artery, common hepatic artery, and cystic artery has been well documented. We describe a case of pseudoaneurysm of the common iliac artery presenting after laparoscopic stapled mesh rectopexy. As the benefits of minimal access surgery are extended to more and more procedures, surgeons should recognize the possibility of such a complication.

Aneurysm, False↗
PubMed2006

The endoscopic management of Zenker diverticulum: CO2 laser versus endoscopic stapling.

OBJECTIVE: The purpose of this project was to analyze the endoscopic management of Zenker diverticulum (ZD) using both the CO2 laser and endoscopic stapling techniques. This study compares the two techniques in terms of diverticulum size, onset to oral intake, hospital stay, resolution of symptoms (dysphagia and regurgitation), and complications. STUDY DESIGN: A retrospective consecutive case series was performed at an academic medical center. METHODS: Forty patients underwent an attempted endoscopic resection of the ZD using either the CO2 laser or the endoscopic stapling technique. The two techniques were compared on a variety of parameters, including diverticulum size, hospital stay, onset to oral intake, resolution of symptoms, and complications. Symptom scores were obtained before and after surgery with a patient self-reported scoring report (scale 0-3 for both dysphagia and regurgitation with 0 indicating asymptomatic and 3 severe symptoms). RESULTS: Forty patients underwent an attempted endoscopic management of ZD. Five patients (12.5%) failed endoscopic exposure (four converted to open, one observed). Sixteen patients underwent CO2 laser management and 19 underwent endoscopic stapling. The mean diverticulum size (3.8 cm CO2 laser versus 4.4 cm stapling) was not significantly different for the two groups. Both groups demonstrated a significant decrease in preoperative versus postoperative dysphagia and regurgitation symptoms scores, respectively, CO2 laser dysphagia scores decreasing from 2.75 to 1.38 and the regurgitation score dropping from 1.51 to 0.68, whereas endoscopic stapling dysphagia score decreased from 2.74 to 1.21 and the regurgitation score dropped from 1.37 to 0.53. Overall, 86% of patients demonstrated an onset of liquid intake on postoperative day 1 and the average length of stay was 3.4 days in the CO2 laser group and 1.5 days in the endoscopic stapling (P < .0015). Complications included dental trauma in four patients (two CO2 laser and two stapling) and subcutaneous air in three patients (all three CO2 laser). There were no cases of mediastinitis, recurrent laryngeal nerve injury, fistula, or perioperative death. CONCLUSIONS: The endoscopic management of ZD is a safe and effective technique. The endoscopic stapling technique appears to have an improved efficacy and safety when compared with the CO2 laser technique. The two techniques are compared and contrasted.

Aged↗
PubMed2006

A comparison of three methods of wound closure following arthroplasty: a prospective, randomised, controlled trial.

We carried out a blinded prospective randomised controlled trial comparing 2-octylcyanoacrylate (OCA), subcuticular suture (monocryl) and skin staples for skin closure following total hip and total knee arthroplasty. We included 102 hip replacements and 85 of the knee.OCA was associated with less wound discharge in the first 24 hours for both the hip and the knee. However, with total knee replacement there was a trend for a more prolonged wound discharge with OCA. With total hip replacement there was no significant difference between the groups for either early or late complications. Closure of the wound with skin staples was significantly faster than with OCA or suture. There was no significant difference in the length of stay in hospital, Hollander wound evaluation score (cosmesis) or patient satisfaction between the groups at six weeks for either hips or knees. We consider that skin staples are the skin closure of choice for both hip and knee replacements.

Adult↗