History of mechanical staple surgical suture (review of literature)

Modern surgery is difficult to imagine without mechanical stapling devices. The objective of the study was to trace the continuity of the development of mechanical stapling technology by European and American surgeons. The main step that led to this technological development was the idea of using a simple paper staple for suturing of human tissue. The first time the mechanical stapling device was used on a human was 9th May, 1908 in Budapest. Subsequently, surgeons and engineers of Europe, primarily Hungary (Austria-Hungary) (H. Hultl, V. Fischer, A. von Petz, etc), Germany (H. Friedrich, etc.) and the USSR (V. Gudov, V. Demikhov, P. Androsov, etc) refined the mechanical principles and practical implications of this new technology. By the mid-1950s, two types of devices were manufactured in the USSR for simple suturing tissues such as the pulmonary parenchyma or bronchus and for the construction of anastomosis. The disadvantages of these devices could be attributed the requirement of delicate manual loading of small metal staples into the cartridge and assembling of sterile parts immediately prior to application. A group of surgeons and engineers led by an American thoracic surgeon, Mark Ravitch, managed to overcome these disadvantages by making devices user-friendly, launched their production in the USA and even organized a training network for surgeons wishing to use the new instruments. The history of mechanical stapling devices illustrates the successful realization of novel ideas that were supported by technological advances and the professional ambitions of surgeons.

Preputial circumcision performed with a new mechanical stapling tool. The “langhe disposable circumcision suture device”. Preliminary experiences

The Authors present their preliminary clinical experiences in performing preputial circumcision utilizing a new stapling tool.

An Assessment of the Clinical and Economic Impact of Establishing Ileocolic Anastomoses in Right-Colon Resection Surgeries Using Mechanical Staplers Compared to Hand-Sewn Technique

Purpose. To estimate and compare clinical outcomes and costs associated with mechanical stapling versus hand-sewn sutured technique in creation of ileocolic anastomoses after right sided colon surgery.Methods. A previously conducted meta-analysis was updated for estimates of anastomotic leak rates and other clinical outcomes. A value analysis model was developed to estimate cost savings due to improved outcomes in a hypothetical cohort of 100 patients who underwent right colon surgery involving either mechanical stapling or hand-sewn anastomoses. Cost data were obtained from publicly available literature.Results. Findings from the updated meta-analysis reported that the mechanical stapling group had lower anastomotic leaks 2.4% n=11/457compared to the hand-sewn group 6.1% leaksn=44/715. Utilizing this data, the value analysis model estimated total potential cost savings for a hospital to be around $1,130,656 for the 100-patient cohort using mechanical stapling instead of hand-sewn suturing, after accounting for incremental supplies cost of $49,400. These savings were attributed to lower index surgery costs, reduced OR time costs, and reduced reoperation costs driven by lower anastomotic leak rates associated with mechanical stapling.Conclusion. Mechanical stapling can be considered as a clinically and economically favorable option compared to suturing for establishing anastomoses in patients undergoing right colon surgery.