title: Preventing a pitfall: no-knife staplers that require caution during handling.
abstract: For safer division of the pulmonary vessels at video-assisted thoracoscopic surgery (VATS), a no-knife stapler (NAW ENDOPATH Flex45 No Knife Endoscopic Linear Stapler, Ethicon Endo-Surgery) is of help. We have used it during 177 sessions in 156 patients and noted two incidences where several of the staples were malformed but did not cause a bleeding event. A close investigation revealed that the cause was excessive rotation of the articulation lever. Thus, to avoid staple malformation, the articulation lever should not be rotated beyond its limit of mobility.
authors.affiliation: Shimonoseki City Central Hospital, Shimonoseki, Japan. yoshidaj@uicalumni.org
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshida
authors.forename: Koichi
authors.initials: K
authors.lastname: Furugaki
mesh_terms: D004867:Equipment Design; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D011651:Pulmonary Artery / Q000601:surgery*; D011667:Pulmonary Veins / Q000601:surgery*; D012399:Rotation; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000009:adverse effects / Q000295:instrumentation*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome