Key points for the operation of disposable laparoscopic cutting staplers

laparoscopic staplers have been widely used in surgery, but standardized and correct methods of use are still very important and need to be mastered by every medical staff. Disposable laparoscopic linear cutter staplers are suitable for tissue transection, resection and anastomosis in thoracic surgery, abdominal surgery and gynecological surgery.

What are the colors and uses of disposable linear cutting stapler stapler?

linear cutting staplers are mainly composed of staplers and staplers. The specifications of each stapler are also different. The following is a summary of 4 stapler colors:

1. Blue staples. The staple height is 3.5mm and the forming height is 1.5mm. It is mainly used for lung tissue resection in thoracic surgery, transverse gastric body, duodenum resection and gastrointestinal side-to-side anastomosis in gastrointestinal surgery.

2. Gold staples. The staple height is 3.8mm and the forming height is 1.8mm. It is mainly used for thicker lung tissue resection in thoracic surgery, thicker parts such as gastric antrum and colon in gastrointestinal surgery.

3. White staples. The height of the stapler is 2.5mm, and the forming height is 1.0mm. It is mainly used for the closure of pulmonary arteries and veins in thoracic surgery, and the closure of the jejunum and ileum in gastrointestinal surgery.

4. Green stapler. The height of the stapler is 4.1mm, and the forming height is 2.0mm. It is mainly used for the closure of lobar and segmental bronchi in thoracic surgery, and the closure of the rectum in gastrointestinal surgery.

Steps and key points for using a disposable linear cutting stapler

1. Install the stapler assembly

Take out the assembly and stapler from the packaging box respectively, align the white arrow on the assembly with the white arrow on the stapler, insert it to the bottom with a little force, then rotate it until you hear a "pop" sound, check the assembly release button, confirm that the assembly is installed in place, and remove the safety plate.

2. Insert the stapler into the body cavity

Press the black handle, close the jaws, and insert it into the body cavity through a suitable puncture. After the head end is completely inserted into the puncture, pull the reset push block back to the end and open the jaws.

3. Compression and firing

Compression before firing:

Place the tissue to be stapled into the jaws to ensure that the tissue is flat and free of tension (after clamping the tissue, if the closed position needs to be adjusted, just push the black handle forward to open the stapler compartment for repositioning).

After positioning, keep the closed state for 15 seconds to allow the tissue to be fully compressed, which can reduce the firing resistance and improve the nailing effect

Press the green safety button, and the black handle will open forward to the firing position. (At this time, the stapler enters the ready-to-fire state)

Start firing:

Grasp the black firing handle at a uniform speed and fire slowly. Each time the firing is completed, the knife moves 15mm. After the firing is completed, the firing handle will be locked. (When installing components of different specifications, the position where the push block stops after firing is different. The stop position of the 30 component is at the scale "30", the stop position of the 45 component is at the scale "45", and the stop position of the 60 component is at the scale "60")

4. Retract the knife & exit the laparoscopic stapler

Pull back the push block, open the jaws, and check the anastomosis.

Consequences and treatment methods of irregular operation

After firing for a short period, it is no longer possible to continue firing.

The stapler's stapler cartridge assembly has an empty nail protection function. When using it, you need to press the green insurance after confirming that the anastomosis position is correct, and fire it once. Once any staple cartridge is fired, it is judged as an empty nail and cannot be used again. Special attention should be paid to avoid misfiring. If the stapler cartridge assembly is used after it has been misfiring, the empty nail protection will be triggered and the stapler will be locked. At this time, you need to pull the push block back to the starting position before you can open the jaws and replace the new stapler cartridge assembly for use.

Problems of not being able to retract the knife due to improper installation

After nailing, there must be a test gun process (i.e. closing and opening the jaws). Only when there is no problem after the test gun can it be fired to avoid the problem of not being able to retract the knife due to improper installation.

The nail magazine cannot be installed

Before nailing, the rotation knob must be returned to the correct position. Removing the nail magazine with a rotation angle may cause the next nail magazine to fail to be installed.