surgical stapling


Summary: A technique of closing incisions and wounds, or of joining and connecting tissues, in which staples are used as sutures.

Top Publications

  1. Choi Y, Bae J, Hur K, Choi D, Kim Y. Reinforcing the staple line during laparoscopic sleeve gastrectomy: does it have advantages? A meta-analysis. Obes Surg. 2012;22:1206-13 pubmed publisher
    ..247-1.266). The current study showed that reinforcing the staple line during LSG has the following advantages: decreased incidence of postoperative leak and overall complications. More prospective studies with better evidence are needed. ..
  2. Musella M, Milone M, Bellini M, Leongito M, Guarino R, Milone F. Laparoscopic sleeve gastrectomy. Do we need to oversew the staple line?. Ann Ital Chir. 2011;82:273-7 pubmed
    ..This randomized trial has so far shown oversew of LSG to be significantly useless to prevent fistulas formation in patients selected according to our study design. ..
  3. Alley J, Fenton S, Harnisch M, Angeletti M, Peterson R. Integrated bioabsorbable tissue reinforcement in laparoscopic sleeve gastrectomy. Obes Surg. 2011;21:1311-5 pubmed publisher
    ..The use of an integrated absorbable synthetic polymer for stapled tissue reinforcement in laparoscopic sleeve gastrectomy appears to be feasible and safe, and yields results consistent with other published techniques. ..
  4. Mitchell I, Barber R, Fischer A, Schindel D. Experience performing 64 consecutive stapled intestinal anastomoses in small children and infants. J Pediatr Surg. 2011;46:128-30 pubmed publisher
    ..These results suggest that stapled bowel anastomosis is an effective approach applicable to a variety of surgical diseases in newborns and infants. ..
  5. Burghardt R, Kanellopoulos A, Herzenberg J. Hemiepiphyseal arrest in a porcine model. J Pediatr Orthop. 2011;31:e25-9 pubmed publisher
    ..However, the unusually rapid rate of growth causes us to recommend more frequent observation periods, such as weekly instead of monthly radiographic observation. ..
  6. Morks A, Havenga K, ten Cate Hoedemaker H, Ploeg R. [C-seal for prevention of anastomotic leakage following colorectal anastomosis]. Ned Tijdschr Geneeskd. 2011;155:A2812 pubmed
    ..To date, 50 patients have been treated with a C-seal. Results are encouraging and therefore the C-seal is soon to be investigated under randomized study conditions. ..
  7. Hirahara N, Tanaka T, Yano S, Yamanoi A, Minari Y, Kawabata Y, et al. Reconstruction of the gastrointestinal tract by hemi-double stapling method for the esophagus and jejunum using EEA OrVil in laparoscopic total gastrectomy and proximal gastrectomy. Surg Laparosc Endosc Percutan Tech. 2011;21:e11-5 pubmed publisher
    ..Then, HDST-based anastomosis was completed. The method may safe laparoscopic anastomosis between the esophagus and reconstructed intestine...
  8. Gorenstein L, Bessler M, Sonett J. Intrathoracic linear stapled esophagogastric anastomosis: an alternative to the end to end anastomosis. Ann Thorac Surg. 2011;91:314-6 pubmed publisher
    ..We present an alternative intrathoracic anastomotic technique to the commonly performed EEA anastomosis. ..
  9. Sciaudone G, Di Stazio C, Guadagni I, Selvaggi F. Rectal diverticulum: a new complication of STARR procedure for obstructed defecation. Tech Coloproctol. 2008;12:61-3 pubmed publisher
    ..STARR procedure can produce new and difficult-to-treat complications and should be reserved for expert colorectal surgeons with proved familiarity in transanal surgery...

More Information


  1. Ganio E, Altomare D, Milito G, Gabrielli F, Canuti S. Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy. Br J Surg. 2007;94:1033-7 pubmed
    ..No significant changes in anal manometric values were found after surgery in either group. Both techniques are effective in the long term. ..
  2. Kent M, Schuchert M, Fernando H, Luketich J. Minimally invasive esophagectomy: state of the art. Dis Esophagus. 2006;19:137-45 pubmed
    ..However, this operation is technically challenging. In this review we detail the procedure as performed in our center, and also discuss some recent developments. ..
  3. Shao W, Li G, Zhang Z, Yang B, Sun G, Chen Y. Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg. 2008;95:147-60 pubmed publisher
    ..001). Stapled haemorrhoidopexy offers some short-term benefits over conventional operation but the total complication rates are similar for both techniques. Stapled haemorrhoidopexy is associated with a higher rate of recurrent disease. ..
  4. Korolija D. The current evidence on stapled versus hand-sewn anastomoses in the digestive tract. Minim Invasive Ther Allied Technol. 2008;17:151-4 pubmed publisher
    ..Nevertheless, proper handling of staplers and experience remain crucial issues if one wants to gain benefits when using these devices. ..
  5. Scherer R, Marti L, Hetzer F. Perineal stapled prolapse resection: a new procedure for external rectal prolapse. Dis Colon Rectum. 2008;51:1727-30 pubmed publisher
    ..This technique has been modified to the perineal stapled prolapse resection. The surgical technique and the preliminary results of the new procedure for external rectal prolapse are presented...
  6. Mattana C, Coco C, Manno A, Verbo A, Rizzo G, Petito L, et al. Stapled hemorrhoidopexy and Milligan Morgan hemorrhoidectomy in the cure of fourth-degree hemorrhoids: long-term evaluation and clinical results. Dis Colon Rectum. 2007;50:1770-5 pubmed
    ..4). No statistical difference was noted in patients' satisfaction after the procedures. Long follow-up seems to indicate more favorable results in Milligan-Morgan procedure in terms of resumption of symptoms and risk of recurrence. ..
  7. Bufo A, Galasse S, Amoroso M. Recurrent severe postoperative bleeding after stapled hemorrhoidopexy requiring emergency laparotomy. Tech Coloproctol. 2006;10:62-3 pubmed
  8. Ben David K, Sarosi G, Cendan J, Hochwald S. Technique of minimally invasive Ivor Lewis esophagogastrectomy with intrathoracic stapled side-to-side anastomosis. J Gastrointest Surg. 2010;14:1613-8 pubmed publisher
    ..There have been no anastomotic strictures to date. A 6-cm side-to-side stapled intrathoracic esophagogastric anastomosis is feasible and is associated with a low anastomotic leak rate. ..
  9. Hasse C, Sitter H, Brune M, Wollenteit I, Lorenz W, Rothmund M. [Haemorrhoidectomy: conventional excision versus resection with the circular stapler. Prospective, randomized study]. Dtsch Med Wochenschr. 2004;129:1611-7 pubmed
    ..Stapler haemorrhoidectomy cures stage 3 haemorrhoids on a long term basis in 84.2 % of patients, costing less than all alternative treatments. In some cases, it can be associated with postoperative complications. ..
  10. Blackmon S, Correa A, Wynn B, Hofstetter W, Martin L, Mehran R, et al. Propensity-matched analysis of three techniques for intrathoracic esophagogastric anastomosis. Ann Thorac Surg. 2007;83:1805-13; discussion 1813 pubmed
    ..Postoperative dysphagia and need for stricture dilation may be decreased using a stapled compared with a traditional hand-sewn anastomosis. ..
  11. Wiemann J, Tryon C, Szalay E. Physeal stapling versus 8-plate hemiepiphysiodesis for guided correction of angular deformity about the knee. J Pediatr Orthop. 2009;29:481-5 pubmed publisher
    ..Higher complication rates are observed in patients with pathologic physes. ..
  12. Buyukasik O, Hasdemir O, Col C. Rectal lumen obliteration from stapled hemorrhoidopexy: can it be prevented?. Tech Coloproctol. 2009;13:333-5 pubmed publisher
    ..5 cm, verifying the existence of a lumen before introducing the stapler and just including the rectal mucosa will minimize the risk of complications. ..
  13. Burghardt R, Specht S, Herzenberg J. Mechanical failures of eight-plateguided growth system for temporary hemiepiphysiodesis. J Pediatr Orthop. 2010;30:594-7 pubmed publisher
    ..No broken plates were reported. In high-risk cases, we now consider using 2 parallel eight-Plates or using solid (not cannulated) screws for plate fixation. Level IV. ..
  14. Thaha M, Irvine L, Steele R, Campbell K. Postdefaecation pain syndrome after circular stapled anopexy is abolished by oral nifedipine. Br J Surg. 2005;92:208-10 pubmed
    ..Men with a high anal sphincter pressure appear to be at risk. Although the exact aetiology remains unclear, it is likely that rectal rather than anal sphincter muscle is affected. Oral nifedipine represents an effective therapy. ..
  15. Bassi R, Rademacher J, Savoia A. Rectovaginal fistula after STARR procedure complicated by haematoma of the posterior vaginal wall: report of a case. Tech Coloproctol. 2006;10:361-3 pubmed
    ..The STARR procedure, even if performed according to a rigorous application of the methodological standards, may be followed by a RVF possibly due to a blood collection leading to ischaemia of the vaginal wall. ..
  16. Khan R, Fick D, Yao F, Tang K, Hurworth M, Nivbrant B, et al. A comparison of three methods of wound closure following arthroplasty: a prospective, randomised, controlled trial. J Bone Joint Surg Br. 2006;88:238-42 pubmed
    ..We consider that skin staples are the skin closure of choice for both hip and knee replacements. ..
  17. Ellis C. Stapled transanal rectal resection (STARR) for rectocele. J Gastrointest Surg. 2007;11:153-4 pubmed
    ..3%, urgency in 1.1% and incontinence of flatus in 1.1% of patients. These data suggest that the STARR procedure is an effective management option for obstructed defecation with an acceptable risk of complications. ..
  18. Shelygin Y, Chernyshov S, Rybakov E. Stapled ileostomy closure results in reduction of postoperative morbidity. Tech Coloproctol. 2010;14:19-23 pubmed publisher
    ..7%) had prolonged ileus, 2 (3.6%) had small bowel obstruction, and 2 (3.6%) had wound infections (P = 0.04). Functional end-to-end anastomosis reduces operating time and morbidity compared to conventional ileostomy takedown. ..
  19. Campos G, Jablons D, Brown L, Ramirez R, Rabl C, Theodore P. A safe and reproducible anastomotic technique for minimally invasive Ivor Lewis oesophagectomy: the circular-stapled anastomosis with the trans-oral anvil. Eur J Cardiothorac Surg. 2010;37:1421-6 pubmed publisher
    ..The circular-stapled anastomosis with the trans-oral anvil allows for an efficient, safe and reproducible anastomosis. This straightforward technique is particularly suited to the completely minimally invasive Ivor Lewis oesophagectomy. ..
  20. Pramateftakis M. The role of hemorrhoidopexy in the management of 3rd degree hemorrhoids. Tech Coloproctol. 2010;14 Suppl 1:S5-7 pubmed publisher
    ..According to our results, stapled hemorrhoidopexy seems to be a safe, pain-free and, in the long-term, effective technique for the treatment of 3rd degree hemorrhoids. ..
  21. Van de Stadt J, D Hoore A, Duinslaeger M, Chasse E, Penninckx F. Long-term results after excision haemorrhoidectomy versus stapled haemorrhoidopexy for prolapsing haemorrhoids; a Belgian prospective randomized trial. Acta Chir Belg. 2005;105:44-52 pubmed
    ..This advantage disappears if any resection is associated with the stapling. At medium to long-term follow-up, PPH seems to carry a higher risk of symptomatic external haemorrhoidal disease, needing further surgery. ..
  22. Takiguchi S, Sekimoto M, Fujiwara Y, Miyata H, Yasuda T, Doki Y, et al. A simple technique for performing laparoscopic purse-string suturing during circular stapling anastomosis. Surg Today. 2005;35:896-9 pubmed
    ..The time for placement of the anvil averaged approximately 8 min. The ring formation following anastomosis was favorable in all patients. As a result, we consider our technique to be simple but very effective. ..
  23. Aykut U, Yazici M, Kandemir U, Gedikoglu G, Aksoy M, Cil A, et al. The effect of temporary hemiepiphyseal stapling on the growth plate: a radiologic and immunohistochemical study in rabbits. J Pediatr Orthop. 2005;25:336-41 pubmed
    ..Temporary hemiepiphyseal stapling is a safe and effective method for control of physeal growth of long bones before skeletal maturity. However, it is of paramount importance not to disturb the periosteum during stapling...
  24. Dodi G, Pietroletti R, Milito G, Binda G, Pescatori M. Bleeding, incontinence, pain and constipation after STARR transanal double stapling rectotomy for obstructed defecation. Tech Coloproctol. 2003;7:148-53 pubmed
    ..Parity, spastic floor syndrome and psychoneurosis seem to be the risk factors predisposing to failure of DSP, which may be followed by severe complications and early recurrence of symptoms requiring reoperation. ..
  25. Goyeneche R, Primomo C, Lambert N, Miscione H. Correction of bone angular deformities: experimental analysis of staples versus 8-plate. J Pediatr Orthop. 2009;29:736-40 pubmed publisher
    ..The correction is faster using a staple and that is the reason why we prefer its usage in patients with little remnant growth. ..
  26. GraviƩ J, Lehur P, Huten N, Papillon M, Fantoli M, Descottes B, et al. Stapled hemorrhoidopexy versus milligan-morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg. 2005;242:29-35 pubmed
    ..Hemorroidopexy is applicable for treating reducible hemorrhoidal prolapse. ..
  27. Jeong O, Park Y. Intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil) after laparoscopic total gastrectomy. Surg Endosc. 2009;23:2624-30 pubmed publisher
    ..We believe that our procedure is a secure and reliable reconstruction method after LTG, which is especially useful in obese patients, in whom conventional extracorporeal anastomosis often is difficult. ..
  28. Boccasanta P, Venturi M, Roviaro G. Stapled transanal rectal resection versus stapled anopexy in the cure of hemorrhoids associated with rectal prolapse. A randomized controlled trial. Int J Colorectal Dis. 2007;22:245-51 pubmed
    ..The anal dilator can be used for selecting the surgical technique. ..
  29. Horisberger K, Beldi G, Candinas D. Loop ileostomy closure: comparison of cost effectiveness between suture and stapler. World J Surg. 2010;34:2867-71 pubmed publisher
    ..005). Operative time using the stapler only is significantly shorter than with hand-sewn anastomosis or combinations of stapler and suture. Operative costs are significantly higher for a procedure that includes suture and stapler. ..
  30. Huang W, Lin P, Chin C, Yeh C, Hsieh C, Chang T, et al. Stapled hemorrhoidopexy for prolapsed hemorrhoids in patients with liver cirrhosis; a preliminary outcome for 8-case experience. Int J Colorectal Dis. 2007;22:1083-9 pubmed
    ..There were no leading symptoms of relapsing during a follow-up period of at least 6 months. This study may prove that stapled hemorrhoidopexy is a feasible and safe approach for prolapsed hemorrhoids concurrent with liver cirrhosis. ..
  31. Cadiere G, Dapri G, Himpens J, Fodderie L, Rajan A. Ivor Lewis esophagectomy with manual esogastric anastomosis by thoracoscopy in prone position and laparoscopy. Surg Endosc. 2010;24:1482-5 pubmed publisher
    ..Thoracoscopy in the prone position allows the surgeon to perform a thoracoscopic esogastric anastomosis completely handsewn without selective lung desufflation, and using only three trocars. ..
  32. Brusciano L, Ayabaca S, Pescatori M, Accarpio G, Dodi G, Cavallari F, et al. Reinterventions after complicated or failed stapled hemorrhoidopexy. Dis Colon Rectum. 2004;47:1846-51 pubmed
    ..Because of the wide spectrum of different interventions required, a failed or complicated stapled hemorrhoidopexy might be better treated by an experienced colorectal surgeon. ..
  33. Fujii H, Aotake T, Kawakami Y, Okuda Y, Doi K, Hirose Y, et al. Modified hemi-double-stapling technique combined with the temporal abdominal-wall-lift method for performing Billroth I anastomosis after laparoscopically assisted distal gastrectomy. Surg Endosc. 2008;22:2748-52 pubmed publisher
    ..One-knot setup HDS combined with the temporal abdominal wall-lift method is considered a safe and simple method for performing Billroth I anastomosis in laparoscopic distal gastrectomy. ..
  34. Slawik S, Kenefick N, Greenslade G, Dixon A. A prospective evaluation of stapled haemorrhoidopexy/rectal mucosectomy in the management of 3rd and 4th degree haemorrhoids. Colorectal Dis. 2007;9:352-6 pubmed
    ..Stapled haemorrhoidopexy/rectal mucosectomy is a safe, effective and predictable treatment of third- and fourth- degree haemorrhoids and in the majority of patients can be carried out on a day case basis. ..
  35. Tjandra J, Chan M. Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy). Dis Colon Rectum. 2007;50:878-92 pubmed
    ..07; P = 0.82) reintervention after the two procedures was similar. The Procedure for Prolapse and Hemorrhoid (stapled hemorrhoidopexy) is safe with many short-term benefits. The long-term results are similar to conventional procedure. ..
  36. Leung T, MacLean A, Buie W, Dixon E. Comparison of stapled versus handsewn loop ileostomy closure: a meta-analysis. J Gastrointest Surg. 2008;12:939-44 pubmed
  37. McDonald P, Bona R, Cohen C. Rectovaginal fistula after stapled haemorrhoidopexy. Colorectal Dis. 2004;6:64-5 pubmed
  38. Aumann G, Petersen S, Pollack T, Hellmich G, Ludwig K. Severe intra-abdominal bleeding following stapled mucosectomy due to enterocele: report of a case. Tech Coloproctol. 2004;8:41-3 pubmed
    ..The serosa defect was sutured and a diverting sigmoid stoma was carried out. The patient left the hospital 10 days later. We emphasize vigilance for undetected enteroceles in mucosal prolapse syndrome combined with defecation problems. ..
  39. Petersen S, Hellmich G, Schuster A, Lehmann D, Albert W, Ludwig K. Stapled transanal rectal resection under laparoscopic surveillance for rectocele and concomitant enterocele. Dis Colon Rectum. 2006;49:685-9 pubmed
    ..The combination of the stapled transanal rectal resection procedure and laparoscopy provides the opportunity to perform transanal rectal resection without the threat of intra-abdominal lesions caused by enterocele. ..
  40. Angelone G, Giardiello C, Prota C. Stapled hemorrhoidopexy. Complications and 2-year follow-up. Chir Ital. 2006;58:753-60 pubmed
  41. Cooke D, Lin G, Lau C, Zhang L, Si M, Lee J, et al. Analysis of cervical esophagogastric anastomotic leaks after transhiatal esophagectomy: risk factors, presentation, and detection. Ann Thorac Surg. 2009;88:177-84; discussion 184-5 pubmed publisher
    ..Screening barium swallow identifies few postoperative complications, but provides quality control. ..
  42. Beldi G, Vorburger S, Bruegger L, Kocher T, Inderbitzin D, Candinas D. Analysis of stapling versus endoloops in appendiceal stump closure. Br J Surg. 2006;93:1390-3 pubmed
    ..001). Application of a stapler for transection and closure of the appendiceal stump in patients with acute appendicitis lowered the risk of postoperative intra-abdominal surgical-site infection and the need for readmission to hospital. ..
  43. Huang W, Chin C, Yeh C, Lin P, Wang J. Randomized comparison between stapled hemorrhoidopexy and Ferguson hemorrhoidectomy for grade III hemorrhoids in Taiwan: a prospective study. Int J Colorectal Dis. 2007;22:955-61 pubmed
    ..This study confirms that SH generates less postoperative suffering, less time off work, and more complete resolution of primary symptoms associated with hemorrhoids in the mid-term follow-up than FH. ..
  44. Kuwabara Y, Shinoda N, Sato A, Kimura M, Ishiguro H, Sugiura H, et al. Billroth I gastroduodenostomy using a hemi-double stapling technique. J Am Coll Surg. 2004;198:670-2 pubmed
  45. Brown S, Woo E. Surgical stapler-associated fatalities and adverse events reported to the Food and Drug Administration. J Am Coll Surg. 2004;199:374-81 pubmed
    ..It is important for health-care providers to report adverse events to manufacturers so that they may work to improve the design of these devices and reduce use errors that contribute to the events. ..
  46. Corman M, Carriero A, Hager T, Herold A, Jayne D, Lehur P, et al. Consensus conference on the stapled transanal rectal resection (STARR) for disordered defaecation. Colorectal Dis. 2006;8:98-101 pubmed
  47. Joo Y, Moon H, Lee S, Jeong C, Jung E, Hong S, et al. Laparoscopy-assisted distal gastrectomy with intracorporeal Billroth I stapled anastomosis using a hand access device for patients with gastric cancer. Surg Endosc. 2007;21:859-62 pubmed
    ..The authors believe that this novel technique can guide an accurate laparoscopic anastomosis for the surgeon dealing with obese patients who have distal gastric cancer. ..
  48. Toh Y, Sakaguchi Y, Ikeda O, Adachi E, Ohgaki K, Yamashita Y, et al. The triangulating stapling technique for cervical esophagogastric anastomosis after esophagectomy. Surg Today. 2009;39:201-6 pubmed publisher
    ..05). Cervical esophagogastric anastomosis using TST may reduce the frequency of anastomotic leakage and stenosis. This technique is a safe and reliable alternative for CEGA after esophagectomy. ..
  49. Khubchandani I, Fealk M, Reed J. Is there a post-PPH syndrome?. Tech Coloproctol. 2009;13:141-4; discussion 144 pubmed publisher
    ..Persistent bleeding from hemorrhoidal disease distal to the staple line requires further management and raises the question as to the use of PPH as a permanent remedial procedure. ..
  50. Chen B, Kiriakopoulos A, Tsakayannis D, Wachtel M, Linos D, Frezza E. Reinforcement does not necessarily reduce the rate of staple line leaks after sleeve gastrectomy. A review of the literature and clinical experiences. Obes Surg. 2009;19:166-72 pubmed publisher
    ..Because the leak rate is small, the routine reinforcement of the staple line after sleeve gastrectomy is questionable at best, although a decrease in hemorrhage has been reported. ..
  51. Baker R, Foote J, Kemmeter P, Brady R, Vroegop T, Serveld M. The science of stapling and leaks. Obes Surg. 2004;14:1290-8 pubmed
    ..Finally, three leak studies evaluating ways to optimize staple-line strength are presented, and a large bariatric clinical series is reviewed. ..
  52. Wrighton L, Curtis J, Gollin G. Stapled intestinal anastomoses in infants. J Pediatr Surg. 2008;43:2231-4 pubmed publisher
    ..When permitted by intestinal size in infants younger than 1 year, stapled anastomoses were safe and effective and significantly reduced operative time. ..
  53. Giordano P, Gravante G, Sorge R, Ovens L, Nastro P. Long-term outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy: a meta-analysis of randomized controlled trials. Arch Surg. 2009;144:266-72 pubmed publisher
    ..It is the patient's choice whether to accept a higher recurrence rate to take advantage of the short-term benefits of SH. ..