title: Effect of Tri-Staple Technology and Slow Firing on Secure Stapling Using an Endoscopic Linear Stapler.
abstract: OBJECTIVE
  To evaluate the effect of Tri-staple technology and slow firing using the Endo-GIA endoscopic linear stapler.
  
  
  METHODS
  The cardiac and pyloric portions of porcine stomachs were divided using the endoscopic linear stapler with different reload types. A total of 8 min of waiting time was employed during firing in the slow-firing group and no waiting time was employed in the normal-firing group. The shape of the staples was then evaluated. The length of the staple line and serosal laceration was also determined.
  
  
  RESULTS
  There was a moderate negative correlation between tissue thickness and secure staple formation. Tri-staple reloads (purple, black) offered more secure staple formation compared with Universal green reload. Although slow firing enhanced secure staple formation, its effect was greater when using green reload, compared with Tri-staple reloads. Significantly shorter staple line length and longer serosal laceration was observed in the thick tissue. Although the cartridge type did not influence lengths of the staple line or serosal laceration, both were better in the slow-firing group.
  
  
  CONCLUSIONS
  Tri-staple reloads offered more secure staple formation compared with the Universal reload. Although slow firing improved staple line shortening and serosal laceration, its effect on secure stapling was relatively small when using Tri-staple reloads.
authors.affiliation: Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Shinya
authors.initials: S
authors.lastname: Nakayama
authors.forename: Koya
authors.initials: K
authors.lastname: Hida
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawada
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sakai
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation*; D013270:Stomach / Q000601:surgery*; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000295:instrumentation* / Q000379:methods; D013552:Swine