title: Secure overlap stapling using a linear stapler with bioabsorbable polyglycolic acid felt.
abstract: BACKGROUND
  Despite the availability of various anastomosis techniques, postoperative anastomotic complications such as anastomosis failure and bleeding develop in some patients. Automatic suturing devices have been widely used for gastrointestinal anastomosis. However, overly thick or thin tissue, displacement of tissue, and the creation of a staple-on-staple site may lead to incomplete staple formation. These factors are considered to be related to postoperative complications such as anastomosis failure.
  
  
  METHODS
  The iDrive™ Ultra Powered Stapling System was used to fire the automatic suturing device. Two types of automatic suturing devices were employed: (i) the Endo GIA™ Reinforced Reload with Tri-Staple™ Technology with a cartridge with the reinforcement material Neoveil™; and (ii) the Endo GIA™ with Tri-Staple™ Technology with no reinforcement material. Stapling was performed using a two-stage crossing approach to make a staple-on-staple site.
  
  
  RESULTS
  The rates of complete formation with the Endo GIA™ with Tri-Staple™ Technology were 95.6 ± 0.6% for stomach tissue and 95.6 ± 2.3% for colon tissue, which is thinner than stomach tissue. In contrast, the rates of complete formation with the Endo GIA™ Reinforced Reload with Tri-Staple™ Technology were 99.3 ± 1.27% for stomach tissue and 100.0 ± 0.0% for colon tissue.
  
  
  CONCLUSIONS
  Our results showed that the Endo GIA™ Reinforced Reload with Tri-Staple™ Technology had higher rates of complete staple formation than the Endo GIA™ with Tri-Staple™ Technology, irrespective of tissue thickness and the presence of a staple-on-staple site.
authors.affiliation: Department of Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Naito
authors.affiliation: Department of Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamanashi
authors.affiliation: Department of Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Miura
authors.affiliation: Department of Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Tsutsui
authors.affiliation: Department of Surgery, Kitasato University, School of Medicine, Sagamihara, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D020341:Absorbable Implants; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D000818:Animals; D003106:Colon / Q000601:surgery*; D011100:Polyglycolic Acid; D013270:Stomach / Q000601:surgery*; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000295:instrumentation* / Q000379:methods; D013552:Swine
chemical_list: D011100:Polyglycolic Acid
keywords: PGA felt; stapling; surgical stapler