Investigation of Staple Height Effects on Tissue Oxygenation and Blood Flow following Surgical Transection

Ian Graham, Marisha L Godek, PhD, MS, Michael Stellon, Sally Carter, MS, Andrew Miesse, MS, Dwight G Bronson, MS

Covidien Surgical Solutions

Objective: To examine the relationship between staple height and tissue reperfusion by measuring blood flow and tissue oxygenation of staple lines with a range of final closed staple heights.

Description of Technology: Staple height variability is presumed to contribute to tissue perfusion and healing, i.e., a larger final closed staple height is believed to allow a larger volume or increased rate of blood flow to the compressed tissue as compared to a smaller final closed staple height, potentially promoting tissue recovery. The investigative methods described here examine the relationship between staple height and tissue reperfusion by measuring blood flow and tissue oxygenation of staple lines with a range of final closed staple heights. Briefly, Covidien™ DST Series™ TA 30 devices (n =3 for each of three reloads: white, green and blue) were fired on adult canine small bowel with placement which allowed limited blood flow to the adjacent section of bowel so that the degree of perfusion across the isolated staple line could be measured. A moorVMS™ probe was utilized to capture blood flow and tissue oxygenation values in both control and test sites immediately following transection as well as thirty minutes and two hours later. After initial test measurements were recorded, each section of bowel was devascularized and tissue oxygenation and blood flow were measured.

Preliminary Results: Results indicated that tissue reperfusion occurred when the final closed staple height was greater than or equal to ~2 mm, but no significant tissue reperfusion was observed at a final closed height of ~1.5 mm, suggesting that a greater degree of perfusion occurs as the staple height is increased despite the small differences in the final closed height.

Conclusions: Small changes in final closed staple height may translate to significant changes in tissue reperfusion that could impact tissue health and healing.

Session: Poster Presentation

Program Number: ETP060