Circular Stapler Reduces Colorectal Anastomosis Leaks

An innovative circular powered stapler reduces life-threatening and costly complications following left-sided colorectal resection.

The Ethicon (Cincinnati, OH, USA) Echelon Circular powered stapler combines two proprietary technologies; 3D stapling technology to evenly distribute compression throughout the anastomosis by offsetting closure of the staple legs, and atraumatic gripping surface technology (GST) for gentler handling, which reduces the compressive forces on the tissues needed to prepare them for stapling. The powered push-button firing platform also delivers less movement at the distal tip for increased stability, and drastically reduces the force needed to fire the staple, compared to a manual stapler.

In a recent real-world study, published on May 4, 2021 in Surgical Endoscopy, the Echelon Circular powered stapler, when compared with manual circular staplers, was associated with a 74% reduction in anastomotic leak rates (1.8% versus 6.9%, respectively) and a 44% reduction in 30-day inpatient hospital readmission rates (6.1% versus 10.8%, respectively) following colorectal surgery.

“The data is very positive in terms of postoperative complications and intraoperative events and ease of use, specifically related to the deployment of the circular powered stapler,” said study co-author colorectal surgeon Patricia Sylla, MD, of Mount Sinai Hospital (New York, NY, USA). “While anastomotic leaks are a complex problem with various contributing factors, the results of this study highlight the important role that the surgical stapler can play to reduce the potential for complications in colorectal surgery.”

Most colorectal surgeries include the formation of an anastomosis, and one of the most dangerous complications related to the anastomosis is leakage, occurring in five to 20% of patients. A diverting stoma is the standard of care used to reduce morbidity associated with anastomotic leaks, but it involves a high rate of complications associated with the stoma itself, along with patient discomfort, reduced quality of life, increased hospital stay, additional surgery, and increased medical costs.

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