7, 8 As such, interest exists in the potential difference in outcomes, if any, related to the utilization of these two latest powered stapling technologies. 6 In contrast, Medtronic’s SIG design promotes tissue movement through a single-stage adaptive compression at one of three pre-set device-controlled firing speeds, and a stepped cartridge surface. Ethicon’s GST stabilizes and controls tissue movement through multi-stage compression, gripping surface technology, and surgeon-controlled power. ![]() Though both staplers deliver battery-powered deployment of the staples and the knife, each technology has adopted a different design approach in achieving similar goals of stapling and transection. SIG, launched in 2017, combines a Medtronic powered stapler handle and other components (such as linear adapter, power shell, stapler insertion guide, manual retraction tool etc.) representing a redesign from the original Endo-GIA TM iDrive TM powered stapler, while maintaining same original stapler reloads with Tri-Staple™ technology. GST, launched in 2015, has reload surfaces with proprietary pocket extensions to stabilize and hold in place tissue for the deployment of staples with uniform height. 5Ĭurrently, two powered stapling systems are predominantly used in clinical practice, Ethicon’s GST and Medtronic’s Signia™ Stapling System (SIG). 4 Similar findings have also been reported for VATS lobectomy in Korea, where GST was reported to be associated with lower hemostasis-related complications and lower overall hospital costs as compared with Ethicon’s manual staplers using reloads without GST. 2, 3 Additionally, the incorporation of gripping surface technology (GST) in Ethicon’s ECHELON FLEX™ GST system (GST) has been associated with a lower need for staple line interventions such as endoclip placement, cauterization, and oversewing, in comparison with Ethicon’s powered stapler with standard reloads, among patients undergoing laparoscopic sleeve gastrectomy. ![]() Previous studies have associated powered staplers with a lower risk of hemostasis-related complications (eg, bleeding, transfusion) and lower overall hospital costs when compared with manual staplers in laparoscopic bariatric surgery and video-assisted thoracoscopic (VATS) lobectomy in the United States. In contrast with manual staplers, powered staplers use battery power to drive the knife blade and staples, thus eliminating the variable grip force of the surgeon. 1 Innovation in surgical stapling technology has evolved from manual to power-operated staplers. Surgical staplers are widely used to perform excision of stomach tissue during laparoscopic sleeve gastrectomy, the most common surgical treatment for obesity in the US.
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