A stapler is a device used to place surgical staples on the Skin and tissue. These clamps are used to bring the edges of the skin closer, connect (anastomosis), or remove part of the stomach or intestinal tissue.
This device is usually made of plastic and contains a number of sterile staples. This device is available in both disposable and reusable forms. The disposable type is factory-made and sterilized and discarded after use.
The stapler consists of two parts: the handle and the cartridge.
The stapler has two or three rows of clamps that cut the fabric at the same time and divide it into two parts.
- A sharp razor is inserted in its structure.
Laparoscopic stapler clamps (cartridges), usually made of titanium, stainless steel, or non-absorbent materials Another are made.
History
Stapler was invented by a Hungarian surgeon; Humer Hultl is known as the father of surgical stapler.
In 1909 the Hultl stapler was used to close the abdomen and remove the stomach during surgery It was used but was not used due to its high weight. In 1920 the first stapler was developed.
The global finding was made by Hungarian surgeon Petz and two German surgeons Fredrich and Neuffer.
What is the advantage of using a stapler?
In previous years, before the development of new surgical methods with traditional surgical methods, the pain caused by surgery with a razor or surgical knife was painful for the patient. However, with the advancement of medical science and the introduction of new surgical devices and techniques, it became possible for patients to be treated without worries and concerns.
Nowadays, surgeons prefer to use surgical staples instead of stitches. Its main advantages are as follows:
1-The possibility of blood leakage from a wound closed with a stapler is minimized. In addition to closing the surgical incision site, surgical staples are also useful for reattachment and removal of parts of some organs. For example, a bowel surgery may require cutting off certain parts of the bowel and reconnecting the rest. This can be done more efficiently and accurately using surgical staples.
2- It is easy to use for the doctor.
3- Staple anastomosis is faster than manual suturing technique and therefore the operation time is reduced and finally the patient’s hospitalization time is reduced.
- Reduces the risk of tissue damage and contamination by minimizing tissue handling.
5- Eliminates dead tissue and is reliable.
6- If you use a stapler, the possibility of infection and postoperative complications will be greatly reduced.
- It brings more beauty to the patient’s skin.
8- The patient incurs less cost and pain.
Complications of surgery with a stapler
It should be noted that the possibility of infection, bleeding, damage to the anal walls for several days after surgery should not be ignored.
Types of staplers
. Skin stapler
A skin stapler is a small, portable device that is used instead of stitches. This sewing machine can bring the edges of the wound closer together.
The Skin stapler is made of PVC plastic and a large number of steel punch needles are inserted in it.
The skin stapler is mostly used for hair growth and scalp areas. In this part, the doctor does not need sutures with needles. On the other hand, the edges of the wound do not need to be close together. In the old method of suturing, a lot of pressure was applied to the wound by approaching the edges. Sometimes the wound would bleed again due to pressure, making suturing virtually difficult.
Attributes:
Pain less than stitches
Faster than stitches
Reduce bleeding and improve skin quality
Dermal staplers include two types, disposable and multi-use. Disposable staplers are sterile and should be disposed of after use. In a multi-use skin stapler, the doctor can prepare the punch separately and place it inside this small machine.
.Disposable linear stapler
This tool is used in gastrointestinal and chest operations. This is an L-shaped stapler.
This stapler is mostly used in rectal cancers and reoperations, in which they block both tissues so that they can examine the tissue.
Disposable contour
This stapler is a crow or curved linear stapler. This stapler is used to operate on the last part of the large intestine (usually the last 4 cm).
Because this stapler must be placed in the pelvic arch, it has a curved shape.
Disposable curved cutting stapler has a good capacity for cutting and stitching, the seam can support pressures greater than 3.6Kpa and there is no leakage or discharge. The scale value mark is clear, the active handle switching is flexible.
Different sizes of staplers:
Lengths 60, 80, 100 mm
Staple height from 3.3 to 4.8 mm
Usually smaller diameters are used for esophageal surgery and larger diameters are used for bowel and rectal cancers.
Disposable circular stapler
This instrument is mainly used for anastomosis or to create a connection between different parts of the gastrointestinal tract, especially the colon, in laparoscopic operations. This stapler enters the intestine from inside the anus or by making an incision in the surface of the intestine.
Circular stapler has many features including:
rotation blade system (RBS): allows easy and precise cutting while reducing the risk of tissue damage.
automatic safety lock (ASL): Prevents tissue from burning incorrectly.
Bendos .feeding tube re-entry pulley: protecting the anastomosis orifice.
petal shaped shaft (PSS): Provides easy positioning with a tight connection.
Adjustable staple height from 1 mm to 2.5 mm.
These staplers are available in sizes 17 to 34. Smaller sizes are commonly used in esophageal surgery or for children and adolescents.
Disposable laparoscopic annular stapler
This stapler is similar to a disposable annular stapler, with the difference that the length of the body is longer than the other annular type.
Disposable laparoscopic shear linear stapler
Laparoscopic linear shear staplers are commonly used to cut large arteries, cut and anastomose the esophagus, stomach, intestines and colon. This type of stapler is used in obesity operations such as sleeve, bypass, etc. to cut the stomach. Also in esophageal, colon, etc. operations, this type of stapler can be used to cut and separate cancerous tissue.
Disposable hemorrhoid stapler
Stapler hemorrhoids are used to puncture prolapse (sagging) of the anal mucosa or hemorrhoidal mucosal tissue.
