Serosal Laceration During Firing of Powered Linear Stapler Is a Predictor of Staple Malformation

Fumihiko Matsuzawa, Shigenori Homma, Tadashi Yoshida, Yuji Konishi, Susumu Shibasaki, Takahisa Ishikawa, Hideki Kawamura, Norihiko Takahashi, Hiroaki Iijima, Akinobu Taketomi

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Background. Although several types of staplers have been developed, staple-line leaks have been a great problem in gastrointestinal surgery. Powered linear staplers were recently developed to further reduce the risk of tissue trauma during laparoscopic surgery. The aim of this study was to identify the factors that predict staple malformation and determine the effect of precompression and slow firing on the staple formation of this novel powered stapling method. Methods. Porcine stomachs were divided using an endoscopic powered linear stapler with gold reloads. We divided the specimens into 9 groups according to the precompression time (0/60/180 seconds) and firing time (0/60/180 seconds). The occurrence and length of laceration and the shape of the staples were evaluated. We examined the factors influencing successful stapling and investigated the key factors for staple malformation. Results. Precompression significantly decreased the occurrence and length of serosal laceration. Precompression and slow firing significantly improved the optimal stapling formation rate. Univariate analysis showed that the precompression time (0 seconds), firing time (0 seconds), and presence of serosal laceration were significantly associated with a low optimal formation rate. Multivariate analysis showed that these three factors were associated independently with low optimal formation rate and that the presence of serosal laceration was the only factor that could be detected during the stapling procedure. Conclusions. We have shown that serosal laceration is a predictor of staple malformation and demonstrated the importance of precompression and slow stapling when using the powered stapling method.

Original languageEnglish
Pages (from-to)590-597
Number of pages8
JournalSurgical Innovation
Issue number6
Publication statusPublished - 01-12-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery


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