The principle of stapling of the gastrointestina! tract was best known to surgeons by way of the von Petz instnunent, which was presented on September 1921. The American staplers, which became available in 1967 with disposable sterilely packed praloaded cartridges and. with the radical tranfer of the fine staple drivers and knives to the disposable element, have revolutionized surgical stapling.
The instrument used are represented by a family of seven staplers: the TA 30, TA 55, TA90, and the GIA, EEA, LDS, and skin and fascia staplers. 27 cases of the gastrointestinalsurgery with the Auto-Suture Staplers have been studied during the period of Jan. 1983, to Fed. 1985. at the Department of Surgery, College of Medicine, Chung Nam National University and the clinical analysis and review of literatures were carried out on these cases.
The results were as follows:
1) In 27 cases, 16 were stomach cancer, 6 were congenital megacolon, 3 were rectosiginoid cancer.
2) In 27 cases, 19 were males and 8 were females and the most common age distribution was in the 5th decade.
3) Specific surgery of the 27 cases were as follows ; Total gastrectomy with esophagojejunostomy in 8 cases, partial gastrectomy with gastrojejunostomy (B-ll) in 8 cases, Duhamet´s Procedure for congenital megacolon in 6 cases, low anterior resection of rectosigmoid colon in 2 cases, colostomy repair in 1 case, gastrostomy in 1 case and transverse colectomy in 1 case.
4) Postoperative specific complication developed in 1 case stenosis and there was no mortality in these series.
5) The advantages of the Auto-Suture Staplers are
a) reduction of operating time
b) reduction of blood loss
c) lesser tissue manipulation
d) technical simplicity
e) relatively lower operative mortality
f) more secure and cosmetic closure
Of course, the Auto-Suture stapling technic cannot completely substitute the conventional suturing method, tut with the above mentioned many advantages the use of stapling instrument is well recommended and will contribute more for the development of surgical science.
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