Staples

Design Type of Staplers (Table3)

The most commonly used staples have a rectangular shape and are preloaded in cartridges. The staples are pushed through the tissue under the pressure created by closing the stapler. Once they reach the anvil, the staples are buckled or bent into the final B-shape. The B-form allows both the firm connection and sufficient vascularization of the adapted tissue. Note that the "height" of the staples after the instrument is "fired" is smaller.

In order to achieve a safe anastomosis or closure, the staple height should be adapted to the thickness of the tissue. The staple height is indicated by different colors of cartridges. The majority of staplers in current use are equipped with a fixed staple height.

The staple height is fixed for linear cutters, whereas linear staplers and circular staplers may have somewhat variable staple heights that can be adapted intraoperatively, according to the type of tissue.

Table3. Staple characteristics and applications

Cartridge type

Vascular

Standard

Thick

Color

White

Blue

Green

Staple height

Fixed

Fixed

Fixed

Before B formation

2.5 mm

3.5mm

4.8mm

After B formation

1.0mm

1.5mm

2.0 mm

Applications

Thin tissues

Esophagus

Rectum

Well-vascularized tissues

Small bowel

Stomach

Vessels

Large bowel

Bronchus

Pancreas

Lung

Liver

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