Articoli di riviste: "Stapled"

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Sturiale, Alessandro, Bernardina Fabiani, Claudia Menconi, Danilo Cafaro, Felipe Celedon Porzio e Gabriele Naldini. "Stapled Surgery for Hemorrhoidal Prolapse: From the Beginning to Modern Times". Reviews on Recent Clinical Trials 16, n. 1 (15 febbraio 2021): 39–53. http://dx.doi.org/10.2174/1574887115666200310164519e.

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Introduction: Hemorrhoidal disease is the most common proctologic condition in adults. Among the different surgical procedures, one of the greatest innovations is represented by the stapled hemorrhoidopexy. The history of this technique started with a single stapler use passing through a double stapler technique to resect the adequate amount of prolapse, finally coming to the use of high volume devices. Methods: Nevertheless, each device has its own specific feature, the stapler is basically made up with one or more circular lines of titanium staples whose height may be variable. The procedure is based on different steps: Introduction of the CAD, evaluation of the prolapse, fashioning purse string or parachute suture, the introduction of the stapler head beyond the suture, pull the wires through the window, close the stapler and keep pulled the wires of the suture held together with forceps, fire using two hands, open the stapler and remove it and check the staple line and then check the specimen. One of the latest innovations in stapled surgery is Tissue Selective Therapy. It is a minimally invasive procedure in which there is a partial circular stapled hemorrhoidopexy focused on the prolapsing piles with bridges of normal mucosa left. Results: Several studies have reported that SH is a safe and effective procedure to treat hemorrhoidal prolapse. It is a quicker procedure with a shorter hospital stay and earlier return to work if compared with the conventional treatment. This is due to less postoperative pain, postoperative bleeding, wound complications and constipation. Furthermore, the first generation devices had worse outcomes if compared with those of the new generation stapler that showed lower postoperative complication rates with better anatomical and symptomatic results. Conclusions: Stapled procedure for the treatment of symptomatic hemorrhoidal prolapse represents one of the most important innovations in proctology of the last century bringing with it the new revolutionary concept of the rectal intussusception as a determining factor involved in the natural history of the disease. Stapled hemorrhoidopexy marked an era in which the surgeon may offer the patients a safe, effective treatment with less pain and fast recovery.

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Angotti, Lisa M., Christopher Decker, Brittany Pahwa, Carl Rosati e Todd Beyer. "Internal hernia caused by a free intraperitoneal staple after laparoscopic appendectomy". Case Studies in Surgery 4, n. 1 (17 maggio 2018): 14. http://dx.doi.org/10.5430/css.v4n1p14.

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Background: Laparoscopic appendectomy is the gold standard for treatment of appendicitis. Stapled closure of the appendiceal stump is commonly performed and has several advantages. Few prior cases have demonstrated complications from free staples left within the abdomen after the stapler has been fired.Case report: A 29-year-old female underwent laparoscopic appendectomy for acute uncomplicated appendicitis during which the appendix and mesoappendix were divided using laparoscopic gastrointestinal anastomosis (GIA) staplers. Her initial recovery was uncomplicated. She returned on postoperative day 17 with sharp mid-abdominal pain, obstipation, and emesis. Her abdomen was distended, and she had a mild leukocytosis. Computed tomography (CT) demonstrated twisted loops of dilated small bowel in the right lower quadrant with two transition points, suggestive of internal hernia with closed loop bowel obstruction. Diagnostic laparoscopy was performed through the three prior appendectomy incisions. An adhesion between the Veil of Treves and the mesentery of the ileum caused by a solitary free closed staple, remote from the staple lines, had caused an internal hernia. The hernia was reduced, and the small bowel was noted to have early ischemic discoloration. The adhesion was lysed by removing the staple from both structures. The compromised loops of bowel began to show peristaltic movement and color returned to normal, and the procedure was concluded without resection. She was discharged home the following day.Conclusions: Gastrointestinal staplers are commonly used due to ease of use and low complication rate. It is not uncommon to leave free staples in the abdomen as retrieval can be difficult and time consuming. Our case is only the second in the literature reporting an internal hernia with closed loop bowel obstruction as a complication of retained staples. Choosing the most appropriate size staple load to reduce the number of extra staples, removing free staples, or the use of an endoloop can prevent potentially devastating complications.

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Mari, Francesco Saverio, Luigi Masoni, Umile Michele Cosenza, Francesco Favi, Giammauro Berardi, Anna Dall'Oglio, Fioralba Pindozzi e Antonio Brescia. "The Use of Bioabsorbable Staple-Line Reinforcement Performing Stapled Hemorrhoidopexy to Decrease the Risk of Postoperative Bleeding". American Surgeon 78, n. 11 (novembre 2012): 1255–60. http://dx.doi.org/10.1177/000313481207801135.

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Postoperative staple-line bleeding after stapled hemorrhoidopexy represents a major issue of this procedure, especially in the day surgery setting. In this study we assess the possible benefit of using circular bioabsorbable staple-line reinforcement to reduce the risk of hemorrhage when performing stapled hemorrhoidopexy in a day surgery setting. Patients with symptomatic II to III grade hemorrhoidal disease were randomly assigned into two groups. In Group A we performed a stapled hemorrhoidopexy using PPH33-03® with Seamguard®, a bioabsorbable staple-line reinforcement; in Group B, we used only a PPH33-03® stapler. We evaluated the intraoperative and postoperative staple-line bleeding and, secondarily, the duration of surgery, need for additional hemostatic stitches, and presence of postoperative complications. One hundred patients were enrolled in the study. Group A patients showed a statistically significant decrease of intraoperative bleeding (4 vs 42% in Group B) and hemostatic stitch placement (5.7 vs 42%) with the consequent reduction in mean operative time, postoperative pain, and tenesmus. There were no differences between the two groups in hemorrhoidal disease control or postoperative late complications. The use of bioabsorbable staple-line reinforcement while performing stapled hemorrhoidopexy may allow improvement of the safety of this procedure, especially in a day surgery setting.

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Subhedar, Preeti D., Sameer H. Patel, Peter J. Kneuertz, Shishir K. Maithel, Charles A. Staley, Juan M. Sarmiento, John R. Galloway e David A. Kooby. "Risk Factors for Pancreatic Fistula after Stapled Gland Transection". American Surgeon 77, n. 8 (agosto 2011): 965–70. http://dx.doi.org/10.1177/000313481107700811.

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The objective of this study was to identify risk factors for pancreatic fistula (PF) after stapled transection in distal pancreatectomy (DP). Patients undergoing DP using a stapler for transection between 2005 and 2009 were identified from a pancreatic resection database. Variables examined included patient and tumor characteristics, staple size, and the use of mesh reinforcement. Univariate and multivariate regression analyses were performed to identify risk factors for postoperative PF. One hundred forty-nine had stapled transection, and of these, 25 (17%) had mesh reinforcement. The overall morbidity and mortality rates were 28 per cent and less than 1 per cent; 34 (23%) were diabetic. The rate of clinically significant PF was 14 per cent. On univariate analysis, diabetes ( P = 0.04), a firm pancreas ( P = 0.03), use of mesh staple line reinforcement ( P = 0.02), use of a 4.1-mm staple cartridge ( P = 0.01), and blood loss greater than 100 mL ( P = 0.01) were associated with higher pancreatic fistula rates. On multivariate analysis, only the presence of diabetes (OR, 4.17; 95% CI, 1.1-15.3; P = 0.03) and the use of a 4.1-mm cartridge (OR, 8.57; 95% CI, 1.2-60.2; P = 0.03) were independently associated with pancreatic fistula formation. Stapled pancreatic transection provides an acceptable PF rate after DP. Diabetes and staple size influence PF rates. In our experience, use of mesh staple line reinforcement did not reduce the incidence of PF after stapled transection.

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Marcet, Jorge, Andrea Ferrara, David E. Rivadeneira, Jose Erbella e Harry T. Papaconstantinou. "Prospective, Multicenter Randomized Controlled Trial Comparing Two Hemorrhoidopexy Staplers: The HEMOSTASIS Study". International Surgery 103, n. 3-4 (1 marzo 2018): 129–38. http://dx.doi.org/10.9738/intsurg-d-15-00171.1.

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The objective of this study was to compare two hemorrhoidopexy staplers (EEA versus PPH03). Stapled hemorrhoidopexy is a treatment option for patients with symptomatic internal hemorrhoids who have failed more conservative measures. However, staple line bleeding remains common. Recent improvements in stapler design have attempted to reduce intraoperative bleeding and the need for intervention. HEMOSTASIS is a prospective, multicenter, 1:1 randomized controlled trial. Twelve hospital centers in the United States enrolled participants between 18 and 85 years of age with symptomatic grades 2 to 3 internal hemorrhoids. The primary end point was intraoperative bleeding, defined as bleeding requiring intervention (e.g., placement of sutures, cauterization, or ligation to achieve hemostasis). Secondary end points included staple line location, postoperative pain, quality of life, operative time, length of hospital stay, adverse events, and complication rates. On the primary end point, the rates of intraoperative bleeding requiring intervention were 41.0% (32 of 78) with EEA and 70.4% (50 of 71) with PPH (P < 0.001). Treatment for active bleeding was required in 30.8% versus 57.7% (P < 0.001) in the EEA and PPH arms, respectively. There were no significant differences between groups in postoperative pain. Adverse events and perioperative complication rates were generally mild/moderate and were similar between groups: 74.1% (60 of 81) of patients in the EEA group reported at least one adverse event versus 80.9% (55 of 68) in the PPH group (P = 0.32). Intraoperative bleeding occurred less often after stapled hemorrhoidopexy with the EEA stapler compared with the PPH03 stapler. Intervention to achieve hemostasis was required less often with the EEA stapler.

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ALKAN, Murat, Kamuran TUTUŞ, Selcan TÜRKER ÇOLAK, Ender FAKIOĞLU, Şeref Selçuk KILIÇ, Onder OZDEN e Recep TUNCER. "Comparison of stapler and hand-sewn roux en Y jejunal anastomosis in children". Cukurova Medical Journal 47, n. 4 (28 dicembre 2022): 1424–30. http://dx.doi.org/10.17826/cumj.1091286.

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outcomes of stapled and hand-sewn Roux-en-Y intestinal anastomoses in childhood. Materials and Methods: At a university hospital, the records of the children who underwent roux-en-Y anastomosis between December 2007 and December 2014 were reviewed. The data were compared according to the roux-en-Y anastomosis technique used (stapled versus hand-sewn). Results: A total of 52 patients had undergone roux-en-Y anastomosis. All had biliary atresia or choledochal cyst. Thirty-one of the patients were diagnosed with biliary atresia and 21 with choledochal cysts. Staple anastomosis technique was used in 16 of the patients with biliary atresia and 9 of the patients with choledochal cyst. Both in biliary atresia and choledochal cyst cases; operations with stapled anastomosis were significantly shorter than the ones with hand-sewn anastomosis. Among the biliary atresia cases, post-operative oral feeding was initiated significantly earlier in the stapled group, with its lower risks of post-operative cholangitis and longer hospital stay than 7 days. Conclusion: This is the first study in children, confirming the time-saving advantage of stapled anastomosis over hand-sewn, during roux-en-Y anastomosis for biliary atresia and choledochal cyst; along with the safety of stapler use, including the neonates. Stapled anastomosis yields lower complication rates, faster function gain with earlier feeding and hospital discharge.

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Sato, Masaaki. "Strategies to improve the accuracy of lung stapling in uniportal and multiportal thoracoscopic sublobar lung resections". European Journal of Cardio-Thoracic Surgery 58, Supplement_1 (12 marzo 2020): i108—i110. http://dx.doi.org/10.1093/ejcts/ezaa051.

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Abstract The challenges in video-assisted thoracic surgery for sublobar lung resection include difficulty in tumour localization by palpation and difficulty in determining appropriate resection lines. Virtual-assisted lung mapping (VAL-MAP), a bronchoscopic preoperative multispot lung dye-marking technique, allows for both tumour localization and determination of resection lines. To facilitate stapler-based resection, the AMAGAMI or ‘incomplete grasping’ stapler technique is useful to adjust the alignment of the stapler and resection lines. However, when the lung tissue to be stapled is thick, there is unavoidable uncertainty in the staple line inside the lung. We experimentally demonstrated that up to 1 cm of slippage of lung parenchyma occurs at stapling when the stapled lung tissue is >1 cm thick. VAL-MAP 2.0 is a new generation of VAL-MAP combining multispot dye markings with intrabronchial microcoil placement, allowing for 3-dimensional lung mapping and intraoperative navigation using fluoroscopy. The uncertainty of stapling in the lung parenchyma can be partly overcome by VAL-MAP 2.0.

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Gupta, Paritosh, Dhruv N. Kundra, Amanpriya Khanna, Akanksha Aggarwal e Kanu Kapoor. "Our initial experience of three versus two rows circular stapler devices for stapled hemorrhoidopexy: a single institution review of 224 cases". International Surgery Journal 7, n. 3 (26 febbraio 2020): 685. http://dx.doi.org/10.18203/2349-2902.isj20200505.

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Background: Stapled haemorrhoidopexy is a non-excisional approach for haemorrhoids as opposed to conventional open Milligan-Morgan and Ferguson closed haemorrhoidectomy techniques. It repositions the prolapsed haemorrhoid tissue and also causes vascular interruption to the haemorrhoids. This causes faster recovery and lesser post-operative pain.Methods: In authors institute, stapled haemorrhoidopexy was being carried out using two rows proximate PPH circular haemorrhoidal stapler. In February 2018, MIRUS three rows circular stapler was introduced. This is a retrospective observational study carried out at Artemis Hospital, Gurgaon, India. Authors studied records and operative notes of all patients who underwent stapled haemorrhoidopexy between February 2018 and September 2019 and compared key parameters.Results: A total of 224 patients underwent stapled haemorrhoidopexy between February 2018 and September 2019. 116 using MIRUS three rows circular stapler and 108 using two rows proximate PPH circular haemorrhoidal stapler. Most of the studied parameters were comparable with only significant statistical difference seen in higher use of haemostatic sutures in two rows stapler group compared to three rows stapler group. Haemostatic sutures were needed in three row stapler group for 27 patients and in two rows stapler group for 39 patients.Conclusions: Author’s initial experience shows slightly better haemostasis with three rows stapled haemorrhoidopexy with no significant difference in other parameters.

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Koh, Dean C. S., Denis M. O. Cheong e Kutt Sing Wong. "Stapled Haemorrhoidectomy: Bothersome Staple Line Bleeding". Asian Journal of Surgery 28, n. 3 (luglio 2005): 193–97. http://dx.doi.org/10.1016/s1015-9584(09)60342-0.

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Contini, Elizabeth, Marisha L. Godek, Jennifer M. Whiffen e Dwight G. Bronson. "Ex Vivo Pneumostasis Evaluation of a Variable-Height Staple Design". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 8, n. 4 (giugno 2013): 284–88. http://dx.doi.org/10.1097/imi.0b013e3182a6912a.

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Objective This study examined the effect of using a variable-height staple construct containing three rows of staples with heights of 3.0, 3.5, and 4.0 mm (staple leg length, medial to lateral) versus standard three-row single-height staplers (with staple heights of either 3.5 or 4.8 mm) for pneumostasis in healthy porcine and canine lung parenchyma to determine whether a single stapler that uses variable staple heights could perform as well as, or better than, existing single-height stapling devices. The work presented here used healthy animal tissues, in lieu of diseased tissue, which is extremely difficult to obtain and quantify. Methods Briefly, fresh explanted porcine and canine trachea-lung blocs were used for all testing. Tissue thicknesses were measured with a custom-design spring-loaded caliper before stapling with control and test articles to ensure that the tissue was of “appropriate” thickness for the stapler size (staple height) selected (per manufacturer's instructions for use). All tissue measurements were comparable across each area of lung tested, and both test and control devices were fired into the same tissue thicknesses. After stapling, the lungs were submerged in water, insufflated, checked for air leaks at four discrete (increasing) pressures, and scored using a predetermined scale. Statistical analysis was performed for n = 26 (3.5-mm staples), n = 29 (4.8-mm staples), and n = 26 or 29 (paired to the standard group) for the variable-height stapler (3.0-, 3.5-, and 4.0-mm staples). Results The results demonstrated that the test article comprising three rows of variable-height staples provided comparable pneumostasis with the standard three-row single-height staplers (with staple heights of either 3.5 or 4.8 mm) under the test conditions described. Conclusions A novel test article containing three rows of staples with heights of 3.0, 3.5, and 4.0 mm (variable-height stapler) showed promising results when compared with standard commercially available single-height staplers, performing as well as or better than the standard single-height staplers. This work demonstrates important first steps to proving equivalent device performance, which might facilitate the use of a variable-height stapler in place of multiple single-height staplers.

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Laxa, Bernadette U., Kristi L. Harold e Dawn E. Jaroszewski. "Minimally Invasive Esophagectomy". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 4, n. 6 (ottobre 2009): 319–25. http://dx.doi.org/10.1097/imi.0b013e3181c4fc8b.

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Objective Minimally invasive esophagectomy (MIE) can be performed a variety of ways using different techniques for the anastomosis. End-to-end anastomosis (EEA) transoral circular staplers have traditionally been used in gastric bypass surgery with good success. An evaluation of the safety and utility of the EEA transoral circular stapler for esophageal anastomoses in MIE is reviewed. Methods A retrospective chart review of all patients who underwent transthoracic MIE with EEA-stapled transoral anastomoses between January 2008 and May 2009 was performed. Patient demographics, indication for esophagectomy, perioperative treatments, intraoperative data, postoperative complications, hospital length of stay, and in-hospital mortality were evaluated. Results Twenty-six consecutive patients underwent MIE with EEA circular-stapled transthoracic anastomoses. Twenty-three were male with a mean age of 64 years (32–88). Indications for esophagectomy included esophageal cancer (24), high-grade dysplasia (1), and refractory stricture (1). Fifteen patients (63%) had neoadjuvant chemotherapy and radiation. There were no conversions to open thoracotomy or laparotomy. Mean operative time was 6.0 hours. Eight patients (31%) suffered postoperative complications; including leak from the gastric conduit staple line requiring operative intervention (1), postoperative bleeding requiring multiple transfusions (1), aspiration pneumonia (1), acute respiratory distress syndrome (1), myocardial infarction (1), chylothorax (1), and anastomotic stricture (2). Median hospital length of stay was 9 days (range 6–43). There were no in-hospital mortalities. Conclusions In our series, the EEA circular stapler seems technically feasible and relatively safe for an intrathoracic anastomosis in MIE.

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Bernardi, Daniele, Emanuele Asti e Luigi Bonavina. "VS03.08: ANASTOMOTIC TECHNIQUES FOR MINIMALLY INVASIVE TRANSTHORACIC ESOPHAGECTOMY". Diseases of the Esophagus 31, Supplement_1 (1 settembre 2018): 49. http://dx.doi.org/10.1093/dote/doy089.vs03.08.

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Abstract Description Minimally invasive esophagectomy has the potential to reduce the incidence of pulmonary complications and postoperative pain. This video shows two safe and reproducible technical variants for thoracoscopic stapled anastomosis. The patient is placed in a left semi-prone position after induction of anesthesia with a single lumen orotracheal tube. Triportal access and low-pressure pneumothorax (8 mmHg) are used for the procedure. Once circumferential mobilization of the esophagus is completed, intraoperative ultrasonography is performed to identify a previously placed endoscopic metal clip marking the upper tumor level. The esophagus is safely transected above this level. An end-to-side intra-corporeal esophagogastric anastomosis is performed. Technique A. The esophagus is stapled with a 60 mm cartridge (EndoGIA™ Tri-Staple™ purple). The anvil of a 25 mm circular stapler (OrVil™) is inserted transorally and retrieved through a small hole in the esophageal stump. Technique B. The 25 mm anvil is inserted through a transverse esophagotomy with a 7 cm long 2–0 polypropylene suture attached to the sharp tip. The suture is passed from inside to outside of the esophageal lumen. The esophagus is then divided distal to the anvil with an linear stapler. At this point, the anvil is pulled out with a gentle traction close to the stapled line. In both techniques, the circular stapler is introduced into the chest cavity through a mini-thoracotomy at the level of lowermost trocar and a wound retractor (Alexis™) is used. The head of the circular stapler, sealed with a surgical glove cutted at the middle finger, is then introduced into the gastric tube through a small gastrotomy on the lesser curvature. The tip of the gastric tube is perforated close to the greater curvature and engage the esophageal anvil. After checking the doughnut, transection of the remnant gastric tube is completed with a linear stapler and the specimen is retrieved through the mini-thoracotomy. Disclosure All authors have declared no conflicts of interest.

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Mohammed, Serbin, Kavitha Jayanthi Balachandran, S. Vineed e Meer M. Chisthi. "Stapled versus open haemorrhoidectomy: a prospective study". International Surgery Journal 7, n. 11 (23 ottobre 2020): 3740. http://dx.doi.org/10.18203/2349-2902.isj20204682.

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Background: In this era of staplers and advanced techniques in surgery Milligan Morgan technique of open haemorrhoidectomy is still considered as gold standard procedure for symptomatic haemorrhoids. Stapler haemorrhoidectomy, even though it is practiced in many centres has not become common due to various factors. The present study was done to compare the efficacy, safety and advantages, if any, of the stapled haemorrhoidectomy to open procedure.Methods: This prospective study was performed in the department of general surgery, Government medical college, Thiruvananthapuram, Kerala over a period of 12 months from March 2015 to March 2016. Symptomatic patients with grade 3 and4 haemorrhoids were selected for the study. The patients were randomized into two equal groups of 20 each. Group A underwent conventional open haemorrhoidectomy and group B, stapled haemorrhoidectomy.Results: Mean operative time period for group A was 39.25 ±5.5 minutes and group B was 26.75±4.7 minutes. There was significant difference in the pain score between these procedures on first 3 post-operative days. There was also significant difference in group A and group B which was 6.55±1.099 and 3.55±0.759 days respectively for mean hospital stay and 9.90±1.651 and 5.70±0.865 days respectively for return to normal work.Conclusions: Stapler haemorrhoidectomy is associated with lower pain scores postoperatively and shorter duration of hospital stay with early return to work when compared to conventional open haemorrhoidectomy.

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Rahman, Dr Sharif Mushfaqur, Dr Syed Mahbubul Alom e Dr Gazi Md Salahuddin. "A Comparison between Skin Stapler and Polypropylene Sutures in Closing Laparotomy Wounds: A Study of 100 Cases". SAS Journal of Surgery 8, n. 8 (25 agosto 2022): 562–67. http://dx.doi.org/10.36347/sasjs.2022.v08i08.013.

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Objective: Healing of laparotomy wounds is associated with number of factors. The aim of the study was to compare skin stapler and polypropylene sutures in closing laparotomy wounds. Materials and method: This randomized controlled trial study was conducted at the Department of Surgery, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh. The study duration was 6 months, from July 2010 to December 2010. A total of 100 participants were included in the study, divide in two equal groups of 50 participants. The first group received interrupted suture with 2/0 polypropylene. The other group received skin staples. Results: The mean time for closure with suture and staple were 3.7±SD and 22.5±SD cm/min respectively (p- value<0.05). Rate of wound closure was calculated in cm per minute and materials were compared statistically in pairs by t- test. Wounds were closed five times faster with staples then suture (p<0.001). In relation to post-operative infection, 17 (34%) cases developed wound infection in sutured group and 15 (30%) patients in stapled group. Most of the infection occurred in the emergency contaminated cases. There was no significant association between wound infections and method of skin closure (p> 0.05, chi square= 3.15). Conclusions: Staples were well-liked by operators and resulted in substantial and worthwhile savings in time for wound closure.

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Coolman, BR, S. Manfra Marretta, GJ Pijanowski e SL Coolman. "Evaluation of a skin stapler for belt-loop gastropexy in dogs". Journal of the American Animal Hospital Association 35, n. 5 (1 settembre 1999): 440–44. http://dx.doi.org/10.5326/15473317-35-5-440.

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A new method for attachment of a belt-loop gastropexy using disposable, stainless steel skin staples was compared with a traditional hand-sewn belt-loop gastropexy technique in 24 fresh dog cadavers. Mean gastropexy times were 212 seconds for the stapled technique and 435 seconds for the hand-sewn technique. The stapled belt-loop gastropexy was significantly faster than the hand-sewn technique (P less than 0.001). There was no statistically significant difference in the mean maximum tensile strength between the two attachment methods. This study provides a basis for clinical evaluation of the stapled belt-loop gastropexy technique in dogs.

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ARAUJO, Sergio Eduardo Alonso, Lucas de Araujo HORCEL, Victor Edmond SEID, Alexandre Bruno BERTONCINI e Sidney KLAJNER. "LONG TERM RESULTS AFTER STAPLED HEMORRHOIDOPEXY ALONE AND COMPLEMENTED BY EXCISIONAL HEMORRHOIDECTOMY: A RETROSPECTIVE COHORT STUDY". ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 29, n. 3 (settembre 2016): 159–63. http://dx.doi.org/10.1590/0102-6720201600030008.

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ABSTRACT Background: Stapled hemorrhoidopexy is associated with less postoperative pain and faster recovery. However, it may be associated with a greater risk of symptomatic recurrence. We hypothesized that undertaking a limited surgical excision of hemorrhoid disease after stapling may be a valid approach for selected patients. Aim: To compare long-term results after stapled hemorrhoidopexy with and without complementation with closed excisional technique. Method: In a retrospective uni-institutional cohort study, sixty-five (29 men) patients underwent stapled hemorrhoidopexy and 21 (13 men) underwent stapled hemorrhoidopexy with excision. The same surgeons operated on all cases. Patients underwent stapled hemorrhoidectomy associated with excisional surgery if symptoms attributable to external hemorrhoid piles were observed preoperatively, or if residual prolapse or bulky external disease was observed after the firing of the stapler. A closed excisional diathermy hemorrhoidectomy without vascular ligation was utilized in all complemented cases. All clinical variables were obtained from a questionnaire evaluation obtained through e-mail, telephone interview, or office follow-up. Results: The median duration of postoperative follow-up was 48.5 (6-40) months. Patients with grades 3 and 4 hemorrhoid disease were operated on more frequently using stapled hemorrhoidopexy complemented with excisional technique (95.2% vs. 55.4%, p=0.001). Regarding respectively stapled hemorrhoidopexy and stapled hemorrhoidopexy complemented with excision, there was no difference between the techniques in relation to symptom recurrence (43% and 33%, p=0.45) and median interval between surgery and symptom recurrence (30 (8-84) and 38.8 (8-65) months, p=0.80). Eight (12.3%) patients were re-operated after stapled hemorrhoidopexy and 2 (9.6%), after hemorrhoidopexy with excision (p=0.78). Patient distribution in both groups according to the degree of postoperative satisfaction was similar (p=0.97). Conclusion: Stapled hemorrhoidopexy combined with an excisional technique was effective for more advanced hemorrhoid disease. The combination may have prevented symptomatic recurrence associated to stapled hemorrhoidopexy alone.

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Matwiej, Łukasz, Marek Wieruszewski, Krzysztof Wiaderek e Bartosz Pałubicki. "Elements of Designing Upholstered Furniture Sandwich Frames Using Finite Element Method". Materials 15, n. 17 (2 settembre 2022): 6084. http://dx.doi.org/10.3390/ma15176084.

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This paper presents an approach to the design of an upholstered furniture frame using the finite element method and empirical studies. Three-dimensional discrete models of upholstered furniture frames were developed taking into account orthotropic properties of solid pine wood (Pinus sylvestris L.) without and with details strengthening their structure in the form of glue joints and upholstery staples. Using the CAE Autodesk Inventor Nastran finite element method, linear static analyses were performed by simulating normative loading. The finite element method was performed considering the experimentally determined stiffness coefficients of the PCAC adhesive and staple joints. As a result, stress, displacement, and equivalent strain distributions were obtained for upholstered furniture frame models with stapled corner joints. The deformation and strength behavior of the upholstered furniture frames was improved by reinforcing with a wood strip. A new approach to the design of upholstered furniture frame frames using the FEM method with stapled component connections was developed and tested. The results of the study can be applied in the optimization of upholstered furniture construction.

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Narang, Rahul, Sudhir Kalaskar, Hoong-Yin Chong, Rama Ganga, Giovanna da Silva, Steven Wexner e Eric G. Weiss. "Tu1529 Stapled Loop Ileostomy Closure: Does Stapler Length Matter?" Gastroenterology 144, n. 5 (maggio 2013): S—1120. http://dx.doi.org/10.1016/s0016-5085(13)64176-1.

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Richtsmeier, William J. "Myotomy Length Determinants in Endoscopic Staple-Assisted Esophagodiverticulostomy for Small Zenker's Diverticula". Annals of Otology, Rhinology & Laryngology 114, n. 5 (maggio 2005): 341–46. http://dx.doi.org/10.1177/000348940511400502.

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A small Zenker's pouch is a major challenge for endoscopic staple-assisted esophagodiverticulostomy (ESED). This study tested the stapler dimensions so as to identify limitations they impose on ESED. Combining ESED with additional endoscopic suturing could extend the incision and consequently the myotomy. Zenker's diverticulum residual pouch measurements were performed with a previously reported latex glove model and in patients undergoing surgery. Two stapler designs were compared by measuring the residual pouch length for both the stock and modified staplers. One other stapler model cannot be modified without damaging the mechanism. The Endostitch was used to place an additional suture at the apex of the staple line, allowing cutting between the staples while leaving a closed distal incision. All three staplers suitable for ESED leave a residual pouch of 1.5 cm when unmodified. The modified anvil staplers gave a smaller residual pouch by 4 to 5 mm. An additional septal reduction can be accomplished by suturing the area distal to the staple line and incising the party wall beyond the stapler cut. The absolute amount of residual pouch with an additional myotomy is 3 mm. The combined staple-suture technique has proven relatively safe thus far. To provide a maximally efficient myotomy in a patient with a short pouch, the surgeon needs to be aware of the stapler differences. Modifications of the staplers may decrease the depth of the residual pouch, but may carry an added liability. A minimum residual pouch can be achieved with a combination of stapler and suture techniques, but is more technically demanding than the original ESED description.

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Nigam, Vinod Kumar, e Siddharth Nigam. "Redo stapled haemorrhoidopexy: our experience at max hospital, Gurugram". International Surgery Journal 8, n. 2 (29 gennaio 2021): 696. http://dx.doi.org/10.18203/2349-2902.isj20210387.

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Stapled haemorrhoidopexy like any other surgical procedure can also fail due to error by surgeons or machine, the stapler. Experience of the surgeon plays the most important role in avoiding recurrence of haemorrhoid after stapled haemorrhoidopexy. A description of operative technique and patient’s demographics are presented. Ten cases of recurrence of haemorrhoid after stapled haemorrhoidopexy done elsewhere were managed by redo haemorrhoidopexy between 1st June 2011-1st June 2020 at Max hospital, Gurugram, Haryana. All cases were successfully operated though the reason of recurrence was different in these cases. Haemorrhoids or piles are common surgical problem a surgeon faces. The first known mention of this disease is from a 1700 BC Egyptian Papyrus. Stapled haemorrhoidopexy is a new and successful technique to treat haemorrhoids, was developed by Dr. Antonio Longo, Italian surgeon, in 1998.Stapled haemorrhoidopexy avoids formation of wound in the operative area, has the advantage of significantly reducing the post-operative pain. Inadequate knowledge and experience, over confidence, wrong patient selection, improper fixation of circular anal dilator, purse string at wrong site, are common causes of recurrence. We managed the recurrence with taking care of causative factors while doing redo-stapled haemorrhoidopexy successfully in all cases. No case of recurrence of haemorrhoids after stapled haemorrhoidopexy was considered for conventional haemorrhoidectomy. All cases were done with redo-haemorrhoidopexy.

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Meshikhes, Abdul-Wahed N., e Hussain Issa. "Staple Line Polyposis and Cytomegalovirus Infection after Stapled Haemorrhoidectomy". Case Reports in Gastroenterology 4, n. 2 (2010): 204–9. http://dx.doi.org/10.1159/000316634.

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Kim, Jin Sub. "Partial Stapled Hemorrhoidopexy Versus Circular Stapled Hemorrhoidopexy". Annals of Coloproctology 33, n. 1 (28 febbraio 2017): 7–8. http://dx.doi.org/10.3393/ac.2017.33.1.7.

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Jalil, Md Abdul. "Complications after Stapled Hemorrhoidectomy: A Single Center Experience". Annals of International Medical and Dental Research 8, n. 1 (15 gennaio 2022): 235–42. http://dx.doi.org/10.53339/aimdr.2022.8.1.31.

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Background: A circumferential strip of mucosa about 1.5 to 2 centimetres above the dentate line is removed in stapled hemorrhoidectomy, a new technique for haemorrhoids treatments. Objective: The aim of the study was to evaluate complications after stapled hemorrhoidectomy.Methods:A total of 101 patients between the age group 20 to 70 years were diagnosed with grade 3 and grade 4 haemorrhoids. Patients are included in stapled haemorrhoidectomy. The questionnaire focused on stapled hemorrhoidectomy procedures performed in the period July 2018 to June 2020. Descriptive analysis was done based on the student’s T-test using SPSS 24 software version. The level of significance was set at 5% (p < 0.05).Results:In the 2-years timeframe, out of 101 patients in the Immediate (within 1 week) complications of stapled hemorrhoidectomy, 84.16% were in None, 5.94% were severe pain, 3.96% were bleeding, 1.98% were Thrombosis, 0.99% were urinary retention, 1.98% were Anastomotic dehiscence 0.99% were Fissure, 0.99% were perineal intramural hematoma and 0.99% were submucosal abscess. Out of 90.09% were in none, 1.98% were Recurrent hemorrhoids, 0.99% were Severe pain, Stenosis, Fissure, Skin tag, Thrombosis, Staples problems, Intramural abscess and Intussusception.Conclusion:Although stapled hemorrhoidectomy appears to be promising, we believe that a multicenter randomized controlled trial with a long-term follow-up comparing stapled hemorrhoidectomy and banding is required before the treatment can be recommended. The majority of difficulties can be avoided by following the rectal wall anatomy during the surgery.

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Hillman, Robert A., Jonathan W. Nadraws e Michael A. Bertucci. "The Hydrocarbon Staple & Beyond: Recent Advances Towards Stapled Peptide Therapeutics that Target Protein-Protein Interactions". Current Topics in Medicinal Chemistry 18, n. 7 (9 luglio 2018): 611–24. http://dx.doi.org/10.2174/1568026618666180518095255.

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Anomalous protein-protein interactions (PPIs) have been correlated to a variety of disease states, such as cancer, infectious disease, neurological disorders, diabetes, endocrine disorders and cardiovascular disease. Stapled peptides are an emerging intervention for these PPIs due to their improved structural rigidity and pharmacokinetic properties relative to unstapled peptides. This review details the most recent advances in the field of stapled peptide therapeutics, including the increasing variety of PPIs being targeted and types of peptide staples being employed.

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Jalil, Md Abdul, Md Emdadul Hassan, Khadijatul Kobra, Md Omar Faruk e M. Mohibul Aziz. "Stapled and open haemorrhoidectomy; A comperative study of early outcome". Bangladesh Journal of Medical Science 21, n. 2 (25 febbraio 2022): 438–43. http://dx.doi.org/10.3329/bjms.v21i2.58079.

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Background: Stapled Hemorroidectomy is more popular alternative, has higher safety profile, and quickly established than the open Hemorroidectomy procedure. Objective:The study aimed to compare between the early post-operative outcomes of open haemorrhoidectomy and stapled. Methods:A total of 50 patients between the age group 20 to 70years who were diagnosed with grade 3 and grade 4 hemorrhoids, were divided into two groups equally. Stapled haemorrhoidectomy contains 25 Patients undergoing and Open haemorrhoidectomy contains 25 Patients. Comparative analysis between the two groups were done based on student’s T test using SPSS 24 software version. The level of significance was set to 5% (p < 0.05). Results: There were 52% males and 48% females in Stapled haemorrhoidectomy groups and 64% males and 36% females in open haemorrhoidectomy group. 48% patients had grade 3 and 52% had grade 4 haemorrhoids in Stapled haemorrhoidectomy groups, and 44% had grade 3 and 56% had grade 4 haemorrhoids in open haemorrhoidectomy groups. In 16% of patients in stapled haemorrhoidectomy group and 24% of patients in open haemorrhoidectomy group blood loss was seen. In 12% of patients with staple haemorrhoidectomy and in 20% of patients with open haemorrhoidectomy was necessary supportive stitching. 52% of patients in open haemorrhoidectomy was observed residential prolapse but not in stapled haemorrhoidectomy patients. In the stapled group the duration of hospital stay (in days) was 1.96±0.82 days as compared to 3.98±0.78 days in the open group. Comparing to only 4% in the open group, 80% patients were discharged within 2 days in stapled group. In the open group at the end of 4 days 72% were discharged. Conclusions: Open haemorrhoidectomy at Milligan-Morgan is not easy as stapled haemorrhoidectomyinvolves shorter operation, fewer postoperative pain and an analgesic need, shorter hospital stays and a faster rehabilitation, earlier work back, the study confirms. Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 438-443

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Da Silva Pinto, Danielle, Anna Clara Moraes Paro, Daniel Yuji Tanaka, Ana Carla Oliveira Johnen, Pedro Guimenti Ribeiro de Lima, Izabella Dias Muniz de Andrade, Amanda Regina de Souza Marini, Henrique Perobelli Schleinstein e João Kleber de Gentile. "Pneumoperitoneum, retropneumoperitoneum and pneumomediastinum after stapled hemorrhoidopexy". Brazilian Journal of Case Reports 2, n. 4 (28 settembre 2022): 33–40. http://dx.doi.org/10.52600/2763-583x.bjcr.2022.2.4.33-40.

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There are several surgical techniques for the treatment of hemorrhoidal disease, the most used currently being stapled hemorrhoidopexy. Complications of this procedure are rare, although they may occur. The aim of this study is to report the clinical case of a patient with severe complication of rectal perforation after stapled hemorrhoidopexy. A 44-year-old man who presented anal pain in his postoperative period of hemorrhoid with urgent computed tomography evidencing rectal perforation with pneumoperitoneum, retropneumo-peritoneum and pneumomediastinum. Rectal perforation is a specific complication of surgery using stapler. One of the serious consequences is pneumoperitoneum, whose air leaked through the rupture of the rectal wall can reach the mediastinum, causing pneumomediastinum. These complications can be avoided by taking care of the triggering of the stapler device, in addition to post-surgical evaluation, such as rectal exploration before discharge.

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Lau, Yu Heng, Peterson de Andrade, Niklas Sköld, Grahame J. McKenzie, Ashok R. Venkitaraman, Chandra Verma, David P. Lane e David R. Spring. "Investigating peptide sequence variations for ‘double-click’ stapled p53 peptides". Org. Biomol. Chem. 12, n. 24 (2014): 4074–77. http://dx.doi.org/10.1039/c4ob00742e.

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Arif, Saleem, Talat Waseem, Javaid-ur-Rehman Ashraf e Farooq Ahmad. "STAPLED HEMORRHOIDECTOMY". Professional Medical Journal 23, n. 12 (10 dicembre 2016): 1505–12. http://dx.doi.org/10.29309/tpmj/2016.23.12.1806.

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Stapled hemorrhoidectomy has been recently advocated as a procedure of choicefor prolapsed hemorrhoids. Studies consistently show that this newer technique is associatedwith less postoperative pain and may be cost effective; however others have questioned its moregeneralized application. Study Design: Randomized controlled trial. Setting: Tertiary hospitalsettings at Services Institute of Medical Sciences, and Ittefaq Hopsital Trust, Lahore. Period:2002 to 2007. Patients & Methods: Short and long-term outcomes of stapled and conventionalhemorrhoidectomy were compared. 538 patients with Grade II, III & IV hemorrhoids wererandomized to undergo either stapled (n=251) or conventional hemorrhoidectomy (n=287).Perioperative and postoperative complications, length of hospital stay, patient satisfactionand long-term recurrence rates for at least 5 postoperative years were analyzed. Results:In the short term, patients undergoing stapled hemorrhoidectomy (n=251) were associatedwith less operative time, less postoperative pain, shorter hospital stay and acceptable overallfirst post-op year patient satisfaction score as compared to patients undergoing conventionalhemorrhoidectomy (n=287). In the long-term however; there were significantly higher ratesof recurrence and tenesmus in stapled group. Over the postoperative years, these rates ofcomplications increased significantly among patients undergoing stapled hemorrhoidectomy.The subgroup analysis showed that Grade IV patients undergoing stapled hemorrhoidectomyhad higher long term postoperative complication rate and poor patient satisfaction scores asopposed to Grade III hemorrhoid patients and had to undergo secondary surgical interventions.Conclusions: The stapled hemorrhoidectomy is an acceptable treatment for selected patientswith Grade II & III hemorrhoids in terms of less postoperative pain and shorter hospital stayat expense of mildly higher long- term recurrence rate; however for grade IV hemorrhoidsstapled hemorrhoidectomy is clearly is an ‘under treatment’ in the long-term as opposed toconventional hemorrhoidectomy.

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Lal, Pawanindra, Ram Krishan Kajla, Sudhir K. Jain, Jagdish Chander e Vinod K. Ramteke. "Stapled Hemorrhoidopexy". Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 17, n. 6 (dicembre 2007): 500–503. http://dx.doi.org/10.1097/sle.0b013e3180f634f7.

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POVEL, PAUL, e RAJDEEP SINGH. "Stapled Finance". Journal of Finance 65, n. 3 (7 maggio 2010): 927–53. http://dx.doi.org/10.1111/j.1540-6261.2010.01557.x.

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Bellio, Gabriele, Arianna Pasquali e Michele Schiano di Visconte. "Stapled Hemorrhoidopexy". Diseases of the Colon & Rectum 61, n. 4 (aprile 2018): 491–98. http://dx.doi.org/10.1097/dcr.0000000000001025.

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Thomson. "Stapled haemorrhoidectomy". Colorectal Disease 2, n. 5 (settembre 2000): 310. http://dx.doi.org/10.1046/j.1463-1318.2000.00188.x.

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33

Nunoo-Mensah, Joseph W., e Andreas M. Kaiser. "Stapled hemorrhoidectomy". American Journal of Surgery 190, n. 1 (luglio 2005): 127–30. http://dx.doi.org/10.1016/j.amjsurg.2005.03.025.

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Davis, Bradley R. "Stapled Hemorrhoidopexy". Seminars in Colon and Rectal Surgery 18, n. 3 (settembre 2007): 176–80. http://dx.doi.org/10.1053/j.scrs.2007.07.007.

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Stamos, Michael J. "Stapled hemorrhoidectomy". Journal of Gastrointestinal Surgery 10, n. 5 (maggio 2006): 627–28. http://dx.doi.org/10.1007/bf03239965.

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Ortiz, Héctor. "Stapled Hemorrhoidopexy". Diseases of the Colon & Rectum 48, n. 7 (luglio 2005): 1489–90. http://dx.doi.org/10.1007/s10350-005-0020-1.

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Khubchandani, Indru T. "Stapled Hemorrhoidopexy". Diseases of the Colon & Rectum 48, n. 7 (luglio 2005): 1490. http://dx.doi.org/10.1007/s10350-005-0021-0.

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STAMOS, M. "Stapled Hemorrhoidectomy". Journal of Gastrointestinal Surgery 10, n. 5 (maggio 2006): 627–28. http://dx.doi.org/10.1016/j.gassur.2006.01.005.

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Garg, P., G. Sidhu, S. Nair, J. Song, V. Singla, P. Lakhtaria e M. Ismail. "The fate and significance of retained staples after stapled haemorrhoidopexy". Colorectal Disease 13, n. 5 (24 marzo 2011): 572–75. http://dx.doi.org/10.1111/j.1463-1318.2010.02189.x.

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40

Montie, James E., J. Edson Pontes, B. G. Parulkar e Tadd Selby. "W-Stapled Ileal Neo-Bladder Formed Entirely with Absorbable Staples". Journal of Urology 151, n. 5 (maggio 1994): 1188–92. http://dx.doi.org/10.1016/s0022-5347(17)35210-2.

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41

Edwin Conner, W., Allen B. Jetmore e John W. Heryer. "Circular stapled rectal stricturoplasty with the proximate® intraluminal stapler". Diseases of the Colon & Rectum 38, n. 6 (giugno 1995): 660–63. http://dx.doi.org/10.1007/bf02054130.

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42

Guzman, Eduardo A., Rebecca A. Nelson, Joseph Kim, Alessio Pigazzi, Vijay Trisal, Benjamin Paz e Joshua Di Ellenhorn. "Increased Incidence of Pancreatic Fistulas after the Introduction of a Bioabsorbable Staple Line Reinforcement in Distal Pancreatic Resections". American Surgeon 75, n. 10 (ottobre 2009): 954–57. http://dx.doi.org/10.1177/000313480907501020.

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Pancreatic fistula is a major cause of morbidity after distal pancreatic resection. When resections are performed with linear stapling devices, the use of bioabsorbable staple line reinforcement has been suggested to decrease the rate of pancreatic fistula. Our objective was to investigate the incidence of pancreatic fistula when using the Gore Seamguard® staple line reinforcement in stapled distal pancreatic resections. A retrospective review of 30 consecutive patients with stapled distal pancreatectomy was conducted. A broad definition of pancreatic fistula was used. Clinicopathologic factors and outcomes were compared between groups. Pancreatic fistula was diagnosed in 11 of 15 patients (73%) and three of 15 patients (20%) in the Seamguard® and non-Seamguard® groups, respectively ( P = 0.002). Pancreatic parenchymal transection at the neck of the gland was associated with pancreatic fistula, whereas laparoscopic procedures, splenic preservation, or additional organ resection were not. On multivariate analysis, the association between Seamguard® use and pancreatic fistula was significant ( P = 0.005). In conclusion, after introduction of the Gore Seamguard® bioabsorbable staple line reinforcement, we experienced a significant increase in the rate of pancreatic fistula. This experience raises concern about the efficacy of this device in limiting pancreatic fistula after stapled distal pancreatic resection.

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Simmons, Jon D., Joseph W. Gunter, Justin D. Manley, David E. Sawaya e Christopher J. Blewett. "Stapled Intestinal Anastomosis in Neonates: Validation of Safety and Efficacy". American Surgeon 76, n. 6 (giugno 2010): 644–46. http://dx.doi.org/10.1177/000313481007600632.

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The safety and effectiveness of a stapled intestinal anastomosis in adults and children is well documented. However, the role of this technique in neonates is not well validated. We report our experience with stapled intestinal anastomoses in the neonate at the University of Mississippi Medical Center. All patients from the neonatal intensive care unit who had a stapled intestinal anastomosis between February 2007 and May 2008 were identified. A stapled side-to-side functional end-to-end intestinal anastomosis was performed in all patients using a gastrointestinal anastomosis stapler. Demographic, management, and outcome data were collected via chart review. Variables collected included: birth weight, estimated gestational age at birth and surgery, weight at surgery, the use of vasopressors, associated diagnoses, location of the anastomosis, and postoperative clinic visits. A total of 18 patients were identified during the study period. Nine had small bowel to small bowel, eight had ileum to colon, and one had a colon to colon anastomosis. The average weight at time of operation was 2.8 kilograms (Kg) and the average estimated gestational age at surgery was 38.7 weeks. The only complication reported was a partial small bowel obstruction on postoperative day 12, which was successfully treated nonoperatively. Two patients died from problems not associated with the anastomosis. There were no anastomotic leaks or strictures. The literature regarding the use of stapled bowel anastomoses in neonates is scant. Stapled intestinal anastomoses can be performed safely in neonates without a high rate of complication. The long term effects of stapled intestinal anastomoses in the neonate are unknown. Future areas of interest would include effects on postoperative feeding and operative time.

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Min, HoKyun, Hungdai Kim, Hyungook Kim e Won Kon Han. "The Significance of Staple Line Height in a Stapled Hemorrhoidopexy". Journal of the Korean Society of Coloproctology 26, n. 1 (2010): 8. http://dx.doi.org/10.3393/jksc.2010.26.1.8.

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Crafa, F., J. Megevand, G. Romano e P. Sileri. "New double-stapled anastomotic technique to avoid crossing staple lines". Techniques in Coloproctology 19, n. 5 (18 marzo 2015): 319–20. http://dx.doi.org/10.1007/s10151-015-1287-4.

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Jones, Wesley B., Katherine M. Myers, L. Brannon Traxler e Eric S. Bour. "Clinical Results Using Bioabsorbable Staple Line Reinforcement for Circular Staplers". American Surgeon 74, n. 6 (giugno 2008): 462–68. http://dx.doi.org/10.1177/000313480807400602.

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Although linear surgical staple line reinforcement has been shown to increase anastomotic tensile strength in animal models and reduce the incidence of staple line bleeding and anastomotic leaks in colorectal surgery, the benefits of staple line reinforcement on circular stapled anastomoses in bariatric surgery remain unreported in the literature. The purpose if this study was to compare the incidence of anastomotic bleeding, leak, and stricture in patients undergoing laparoscopic gastric bypass with circular staple line reinforcements with those with no circular staple line reinforcements. Since May 2006, 138 consecutive patients (Group B) have undergone laparoscopic Roux-en-Y divided gastric bypass with a 25-mm circular stapled gastrojejunal anastomosis using GORE SEAMGUARD® bioabsorbable circular staple line reinforcement (CBSG) with a mean follow up of 9 months. The incidence of anastomotic bleeding, leak, and stricture was compared with 255 similar patients (Group A) who underwent surgery before May 2006 without gastrojejunal reinforcement with a mean follow up of 22 months. The rates of anastomotic bleeding, leak, and stricture for Group B versus Group A were 0.7 per cent versus 1.1 per cent ( P = 0.64); 0.7 per cent versus 1.9 per cent ( P = 0.34); and 0.7 per cent versus 9.3 per cent ( P = 0.0005), respectively. The use of CBSG reduced the incidence of anastomotic stricture by 93 per cent and the incidence of a composite end point of all anastomotic complications by 85 per cent. Our results indicate that the use of circular staple line reinforcement at the gastrojejunal anastomosis in patients undergoing laparoscopic gastric bypass significantly decreases the incidence of anastomotic stricture and a composite end point of all anastomotic complications. On this basis, strong consideration should be given to the routine use of CBSG staple line reinforcement in patients undergoing laparoscopic divided gastric bypass with a circular stapled gastrojejunal anastomosis.

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Miao, Yanfeng, Sheng Pan e Wei Xu. "Staple Holding Strength of Furniture Frame Joints Constructed of Plywood and Solid Wood". Forests 13, n. 12 (27 novembre 2022): 2006. http://dx.doi.org/10.3390/f13122006.

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The withdrawal and lateral holding properties of three types of plywood with one stapled as well as one-row multi-stapled joints were studied and compared. The results show that variations in plywood density have a significant effect on withdrawal strength and a relatively small effect on lateral holding strength. At four staples, the withdrawal strength of the eucalyptus plywood with a density of 0.59 g/cm3 is 1821 N, which is 21% higher than that of poplar plywood with a density of 0.51 g/cm3 at 1498 N and 32% higher than that of eucalyptus/poplar composite plywood with a density of 0.53 g/cm3 at 1275 N. In terms of lateral holding strength, eucalyptus plywood has a lateral holding strength of 1603 N 12% lower than the 1807 N of eucalyptus/poplar composite plywood and 10% lower than the 1761 N of poplar plywood. As the number of staples increased from 1 to 4 in increments of 1, the withdrawal strength of eucalyptus plywood continued to increase, while the nodal strengths of the poplar plywood as well as eucalyptus/poplar composite plywood did not differ significantly between 3 and 4 staples, and there is a significant increase in the lateral holding strength for all three plywood nodes. Equations for predicting the withdrawal and lateral holding strengths of one-row multi-stapled joints were derived separately.

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Muncie, Colin, Michael Morris, Barry Berch, David Sawaya e Christopher Blewett. "Stapled intestinal anastomoses with endoscopic staplers in premature infants". Journal of Pediatric Surgery 53, n. 1 (gennaio 2018): 126–29. http://dx.doi.org/10.1016/j.jpedsurg.2017.10.024.

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Langenberg, Arthur van. "Per-anal stapled resection of a stapled anastomotic stricture". Annals of the College of Surgeons Hong Kong 6, n. 3 (agosto 2002): 91–93. http://dx.doi.org/10.1046/j.1442-2034.2002.00137.x.

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Neeralagi, Chandrasekhar S., Yogesh Kumar, Surag K. R., Lakkanna Suggaiah e Preetham Raj. "A comparative study of short term results of open haemorrhoidectomy and stapler haemorrhoidopexy". International Surgery Journal 4, n. 10 (27 settembre 2017): 3358. http://dx.doi.org/10.18203/2349-2902.isj20174496.

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Abstract (sommario):

Background: Haemorrhoids are the most common benign anorectal problems worldwide. Treatments of third and fourth degree hemorrhoids include surgical haemorrhoidectomy. Milligan Morgan haemorrhoidectomy (MMH) as described in 1937 has remained the most popular among many techniques proposed. In order to avoid the postoperative drawbacks of Milligan Morgan haemorrhoidectomy, a new surgical treatment for prolapsing haemorrhoids has been described by Longo in 1995, procedure called stapled haemorrhoidopexy which is associated with less postoperative pain and a quicker recovery. The objective of this study was to compare the short-term outcome between stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy.Methods: Prospective randomized study of 120 patients with grade 3 and grade 4 haemorrhoids requiring surgical treatment either MMH or SH, 60 in each group for the period of 18 months from June 2014 to November 2015. Post-operative pain, duration of surgery, duration of hospital stays, post-operative complications and time taken to return to work were compared with mean follow up period of 6 months.Results: Duration of surgery is significantly low in stapled group with P <0.001, duration of hospital stay is significantly low in stapled group with P <0.001, post-operative pain low in staple group with P <0.05, time taken to return to work is significantly early in stapled group with P <0.001. Post-operative complications incontinence not found in the present study but recurrence of two cases in each group noted.Conclusion: Stapled hemorrhoidopexy is associated with less postoperative pain, shorter duration of surgery and hospital stay, earlier return to work as compared with Milligan-Morgan open hemorrhoidectomy. The procedure is not associated with major post-operative complications.

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