What is a gastrointestinal stapler
Gastrointestinal stapler is a medical device used to connect the two ends of the severed organ after the gastrointestinal lesion is removed. Compared with traditional manual suturing, it has the advantages and characteristics of fast suturing, simple operation, few side effects, and can greatly reduce surgical complications.
the use of the gastric stapler
Compared with manual suturing, the cutting stapler can simplify the anastomosis steps and improve suturing efficiency, and is a "weapon" favored by gastrointestinal surgeons.
Taking laparoscopic sleeve gastrectomy as an example, instrument anastomosis usually requires 5-6 cutting staplers, and the gastric cutting anastomosis ends and the junction of the staplers are prone to bleeding. In severe cases, postoperative anastomotic leakage occurs, which is life-threatening. Therefore, conventional manual suture reinforcement is required after instrument anastomosis. However, the gastric cutting anastomosis ends of this operation are as long as 25-30cm, the suture distance is long, the number of sutures is large, and the suture and knotting operation is extremely difficult, which not only prolongs the operation time, but also the suture line is easy to loosen (during continuous suture) and the knot is easy to loosen, thereby increasing the risk of bleeding from the gastric cutting anastomosis ends and anastomotic leakage.
In addition, for patients with acute abdomen caused by perforated gastric and duodenal ulcers, laparoscopic perforation repair is highly recommended due to its small trauma, quick recovery, cosmetic incision, and low complications.
In gastric cancer surgery, the stapler can be used for proximal gastrectomy, esophagogastric anastomosis; total gastrectomy, esophagojejunostomy; distal subtotal gastrectomy, gastroduodenal anastomosis; distal subtotal gastrectomy, gastrojejunostomy.
In colon cancer surgery, it can be used for right hemicolectomy, ileocolic end-to-side anastomosis; transverse colon resection, colon end-to-end anastomosis; sigmoid colon resection, colorectal end-to-end anastomosis
Complications associated with the use of staplers in gastrointestinal tumor surgery include anastomotic leakage, anastomotic bleeding, and anastomotic stenosis. However, the above complications are not only a problem of using staplers, but also can occur with manual anastomosis. The use of staplers greatly reduces the incidence of complications.
In short, instrumental anastomosis is only an auxiliary means, and the use of staplers should still follow the basic principles of surgery, clear anatomy, accurate incision, perfect hemostasis, and reliable suture. Surgeons should be very familiar with the structural principles and performance of staplers, and instrument nurses should be familiar with the components, performance, and optimal indications of various types of staplers.