• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • SAGES 2021 Annual Meeting
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2021
      • SAGES 2020
      • SAGES 2019
      • SAGES 2018
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • SAGES Logo Products
    • “Unofficial” Logo Products
  • Log In

Comparative Study of Three Reinforcement Materials On an Endo Gia™ Reload with Tri-Staple™ Technology

*Andrew J Duffy, MD, **Dwight Bronson, MS, **Jennifer Diederich, MS, **Stephanie Marcucio, MPH, **Nadia Neave, **William Mulligan, ASEE, **Elizabeth Lalime, BS. *Yale University School of Medicine, New Haven, CT, **Covidien, North Haven, CT

INTRODUCTION:
Surgical stapling device technology continues to evolve. Many bariatric and colorectal surgeons use staple line reinforcement in an effort to reduce adverse events such as anastomotic leaks and bleeding. Most stapling devices were not designed with reinforcement products in mind. This study evaluates the performance of two commonly used staple line reinforcement products, W. L. Gore® SeamGuard (GS) and Synovis® PeriStrip™ Dry with Veritas (SV), versus the Covidien Duet TRS™ Reload with Tri-Staple™ Technology (CD). We hypothesize that CD will demonstrate equivalent performance to other staple line reinforcement products on a Tri-Staple™ reload.

METHODS AND PROCEDURES:
We performed multiple firings of 45mm and 60mm CD and Tri-Staple™ reloads with GS and SV in 9 canines. Comparisons were made among 45mm firings on small intestine and for 60mm firings on the stomach. Under stable hemodynamic conditions, we obtained bleeding scores at 30 seconds and 90 seconds after creation of the staple line and division of the tissue. Any bleeding along the staple line after 30 seconds was collected on blotting paper for an additional 60 seconds and weighed on a microbalance. The materials were tested for adherence to the stapler during insertion through a standard 12mm Versaport™ for both 45mm and 60mm length reloads. We also scored the retention during positioning on the bowel and across previously placed staple lines. Undercrimp measurements were obtained on all staple firings as a measure of staple formation. The location of the firings on the stomach and bowel were randomized among the staple line reinforcement materials on each animal. The differences between the observed and expected overall scores were analyzed via the Chi-square test. Where appropriate, a Kruskal-Wallis test comparing medians was also applied.

RESULTS:
All reinforcement products performed as expected with limited significant staple line bleeding. There was no correlation of staple line reinforcement type with tissue thickness and bleeding after staple line creation. No differences were seen in bleeding scores at 30 or 90 seconds, or cumulative bleeding measurements, among types of staple line reinforcement. SG demonstrated significantly more displacement on the stapler head, typically sliding against the insertion force, during introduction through the port for the 45mm and 60mm loads (p<0.01). Similar differences were noted regarding rotation of SG reinforcement on the stapler heads during positioning on the bowel and stomach (p=0.00). CD showed significantly less undercrimp in stomach firings versus SV and GS (p<0.001). SV demonstrated significantly more undercrimp on bowel firings (p<0.001) versus GS and CD.

CONCLUSIONS:
Staple line reinforcement materials performed well with Tri-Staple™ reloads, and provide effective and equivalent hemostasis. CD demonstrated significantly less staple malformation relative to SV and GS on stomach. Significant differences were noted in the adherence of the GS to the staple reload, relative to CD and SV, during both port insertion and stapler positioning. This is likely due to the design of the GS relative to the new Endo GIA™ Reload with Tri-Staple™ head design. The GS requires a redesign to stay reliably positioned on the stapler.


Session: Poster
Program Number: P417
View Poster

2,079

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2011 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Surgery is Safer with Vaccination 1

Addressing Religious Concerns About COVID-19 Vaccine

This may be a difficult subject matter for you and your patient to talk about.  Be assured, all major organized religious groups encourage and recommend the COVID-19 vaccine. Listed below are references and websites you can direct your patient towards to help them make an informed decision with regards to their religious concerns against the […]

SAGES Statement on AAPI Violence

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) stands in solidarity with the Asian American and Pacific Islander (AAPI) community. In the summer of 2020, SAGES released a statement condemning the violence, racism, and hatred toward the Black community in the wake of George Floyd and Breonna Taylor’s murders. It is with great sorrow […]

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
[email protected]
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2022 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2022 Society of American Gastrointestinal and Endoscopic Surgeons