Prospective Randomized Comparison of Linear Endostaplers During Laparoscopic Sleeve Gastrectomy

Raftopoulos, Yannis; Rajkumar, Shruthi; Davidson, Elana; Papasavas, Pavlos

doi:10.1007/s11695-022-06240-4

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…The AEON™ stapler utilizes a three-layer staple technology, like all staplers, but its staple lengths are uniform, and this is a unique difference of AEON™ compared with the other commonly used staplers, which have a graduated staple height, as well as its multi-firing gear to accommodate the thicker tissues (see illustration ). In addition, the increased smoother articulation was subjectively observed, with no bleeding seen along the staple line in any case, similar to a randomized controlled trial in obesity surgery, with the conclusion that the AEON™ stapler causes less bleeding as a result of the staple technology used, but this cannot be ratified without a controlled study ( 12 ).…”

Section: Methodssupporting

confidence: 61%

“…Importantly, the multivarious analysis found that BMI > 30 kg/m 2 , male gender, and an additional procedure undertaken were significant predictors of a pancreatic fistula. The AEON™ stapler utilizes technology not apparent in other staplers with a uniform staple line height (see illustration) with the orange staple cartridge and gear adjustment for use in thicker tissue ( 12 ). One study reported a higher fistula rate in patients with a thicker pancreas (>12mm) ( 22 ), with other studies recommending a gradual graded approach to pancreatic transection, lasting 2 to 3 min as this may reduce the POPF rate ( 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

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Preliminary experience in laparoscopic distal pancreatectomy using the AEON™ endovascular stapler

et al. 2023

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BackgroundThe aim of this study is to investigate the effects of using a new innovative endovascular stapler, AEON™, on the pancreatic leak rates and other outcome measures.MethodsIn a retrospective review of prospectively collected data from a secure tertiary unit registry, patients undergoing distal or lateral pancreatectomy were analyzed for any differences on pancreatic fistula rates, length of stay, comprehensive complication index (CCI), and demographics after using AEON™ compared with other commonly used staplers. Statistical significance was defined as <0.05.ResultsThere were no differences in the demographics between the two groups totaling 58 patients over 2 years from 2019 to 2021. A total of 43 and 15 patients underwent pancreatic transection using other staplers and AEON™ endovascular stapler, respectively. The comparison of the two groups revealed a significantly reduced rate of mean drain lipase at postoperative day 3 with AEON™ (446 U/L) versus the other staplers (4,208 U/L) (p = 0.018) and a subsequent reduction of postoperative pancreatic fistula (POPF) from 65% to 20%. A reduction in the mean CCI, from 13.80 when other staplers were used to 4.97 when AEON™ was used, was also observed (p = 0.087). Mean length of stay was shorter by 3 days in the AEON™ group compared with that in the other staplers (6 and 9 days, respectively; p = 0.018).ConclusionAEON™ stapler when used to transect the pancreas demonstrated a significantly reduced pancreatic fistula rate, length of stay in hospital, and a leaning towards a reduced CCI. Its use should be further evaluated in larger cohorts with the encouraging results to determine whether this is possibly related to the technology used in the design of the AEON™ stapler.

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Section: Methodssupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Preliminary experience in laparoscopic distal pancreatectomy using the AEON™ endovascular stapler

et al. 2023

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“…Presuming that each selected reload is sized to align staple height with target tissue thickness, the staple line geometry of staggered and consistently sized staples may provide a better seal at the transection as compared with graduated staple heights where certain staples may be undersized while others oversized given the target tissue thickness. This difference in design may have contributed to clinical performance 23 …”

Section: Discussionmentioning

confidence: 99%

“…This difference in design may have contributed to clinical performance. 23 Historical 30-day overall complication rates have tended to be higher in patients undergoing laparoscopic RYGB (range: 1.5%-17.2%) 12,13,16,18,24,25 than in patients undergoing laparoscopic SG (range: 2%-8.4%), [12][13][14]25 due to the increased complexity of the operation. LSSD-A and LSSD-B were found to have comparable overall 30-day complication rates, with a trend (P < 0.1) towards fewer overall 30-day complications when treating with LSSD-A.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Alternate Laparoscopic Stapling Device for Bariatric Surgery

Walton,

Broussard

2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: As laparoscopic bariatric surgical techniques have matured, the incidence of complications has decreased over time. Surgical stapling devices are commonly used for resection and anastomosis of gastric tissue during bariatric surgery. The purpose of this study is to assess and compare complication rates and clinical outcomes between patient cohorts using 2 different approved stapling devices. Materials and Methods: Clinical outcomes were retrospectively compared for patients undergoing bariatric surgery between April 2019 and December 2020 using laparoscopic surgical stapling device A (LSSD-A) against outcomes between January 2017 and September 2018 using laparoscopic surgical stapling device B (LSSD-B). Tradenames for LSSD-A and LSSD-B were AEON Endostapler and Endo GIA with Tri-Staple Technology, respectively. Results: In all, 814 patients underwent laparoscopic bariatric operation using LSSD-A and 1034 using LSSD-B. Laparoscopic surgery included sleeve gastrectomy (n=1359, 73.5%), Roux-en-Y gastric bypass (RYGB) (n=425, 23.0%), and single anastomosis duodenoileostomy with gastric sleeve (n=64, 3.5%). Stapler-related complications were evenly distributed over the 20.9-month LSSD-B study period. No stapler-related complications were seen in the last 13 months of the LSSD-A study period, during which time 428 (52.5%) laparoscopic bariatric operations were performed. One staple line leak was observed, occurring in the LSSD-B group. Patients undergoing laparoscopic RYGB with LSSD-A had fewer overall complications, fewer transfusions, and fewer reoperations for staple line bleeding. Conclusions: Both LSSD-A and LSSD-B were safe and effective in the performance of laparoscopic bariatric operations with low complication rates and comparable clinical performance in sleeve gastrectomy and single anastomosis duodenoileostomy with gastric sleeve. Statistically significant differences in complication rates were observed in RYGB favoring LSSD-A.

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Do all roads lead to Rome? A retrospective analysis on surgical technique in sleeve gastrectomy

Vu,

Chiang,

Qian

et al. 2023

Surg Endosc

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Prospective Randomized Comparison of Linear Endostaplers During Laparoscopic Sleeve Gastrectomy

Cited by 3 publications

References 15 publications

Preliminary experience in laparoscopic distal pancreatectomy using the AEON™ endovascular stapler

Preliminary experience in laparoscopic distal pancreatectomy using the AEON™ endovascular stapler

Evaluation of Alternate Laparoscopic Stapling Device for Bariatric Surgery

Do all roads lead to Rome? A retrospective analysis on surgical technique in sleeve gastrectomy

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