Talk track

I understand oozing at the staple line can be a concern given the risk that it may lead to more serious bleeding and complications such as air leaks. As access can be a challenge, addressing those complications can be difficult. Therefore, it is important to choose a stapling device proven to reduce intra-operative bleeding and post operative complications. Not all surgical staplers are created equal, and surgeons have commented to me that they do see oozing and bleeding at the staple line with SureForm™. Our engineers have tested over 150 firings and found that the ECHELON™ 3000 had 2.5 times more consistent average staple height compared to SureForm™.*1 The engineers noticed that staple heights tended to be higher in the middle of the staple line which is interestingly where surgeons often comment they see oozing the most. Consistent staple formation is critical to ensure hemostasis. The ECHELON™ 3000 achieves this by combining multiple features of both the stapler and GST reloads. Firstly, pre-compression, focal compression, and dynamic firing in the stapler all work together to prepare the tissue for firing, exudate fluids, and ensure the powered firing sequence adapts to the variable tissue thickness. The GST reloads include proprietary gripping surface technology that holds tissue in place during firing, minimizing tissue slipping, and allowing you to transect where you intend.2  Most importantly, the inclusion of these features has been shown to improve staple formation and reduce leaks in benchtop testing.3,4 and a clinical study showed a 56% reduction in intraoperative blood loss when comparing ECHELON FLEX™ Powered Staplers with GST Reloads and ECHELON FLEX™ Powered Vascular Stapler vs. manual staplers.5 Results have been confirmed with the ECHELON™ 3000 stapler proving to result in even fewer bleeding complications then the legacy ECHELON™ device. Many surgeons choose to perform a bedside firing with ECHELON™ 3000 in procedures where patients are at higher risk of bleeding complications. I would be happy to attend and support a few of these cases with you to give you the opportunity to ECHELON™ 3000 and see the results for yourself.

Key Messages

  • Consistent compression and staple height formation across the entire staple line is critical to reducing bleeding
  • The SureForm™ stapler has a taller staple height in the middle of the staple line and is often where surgeons report experiencing oozing.*1
  • The ECHELON™ 3000 has 2.5 times more consistent average staple height compared to SureForm™.*1
  • The ECHELON™ family of staplers has demonstrated reduced bleeding complications in clinical studies.5
  • Ask surgeon to trial performing bedside firings with ECHELON™ 3000 in high risk patients.

References

*Ethicon. SureForm Transection Performance Benchmark Ver 9 software. 6/7/2024. Windchill #501978243
1 Ethicon. SureForm Transection Performance Benchmark Ver 9 software. 6/7/2024. Windchill #501978243
2. Ethicon. Evaluation of stomach tissue movement during stapler firing for claims: McLaren vs Signia. 3.9.2021. Windchill Document #500676460
3. Ethicon, Evaluation of Malformed Staples in Thick Tissue for Claims: Echelon 3000 Stapler with GST vs EndoGIA and Signia with Tri-Staple Technology. 6.15.2024. Windchill Document #500697356
4. Ethicon, Ex-Vivo Comparison of Staple Line Leak Pressure: Echelon™ 3000 Stapler with GST vs EndoGIA and Signia ExVivo Staple Line Leak Pressure Comparison against Signia. 7.22.2021. Windchill Document #500700727
5. Park, S. Y., Kim, D. J., Mo Nam, et al.). Clinical and economic benefits associated with the use of powered and tissue-specific endoscopic staplers among the patients undergoing thoracoscopic lobectomy for lung cancer. Journal of Medical Economics, 2019, 22(12), 1274–1280. https://doi.org/10.1080/13696998.2019.1634081.

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