Effects of the closing speed of stapler jaws on bovine pancreases

Background

The division of the pancreatic parenchyma using a stapler is important in pancreatic surgery, especially for laparoscopic surgery. However, this procedure has not yet been standardized.

Methods

We analyzed the effects of the closing speed of stapler jaws using bovine pancreases for each method. Furthermore, we assigned 10 min to the slow compression method, 5 min to the medium-fast compression method, and 30 s to the rapid compression (RC) method. The time allotted to holding (3 min) and dividing (30 s) was equal under each testing situation.

Results

We found that the RC method showed a high-pressure tolerance compared with the other two groups (rapid, 126 ± 49.0 mmHg; medium-fast, 55.5 ± 25.8 mmHg; slow, 45.0 ± 15.7 mmHg; p < 0.01), although the histological findings of the cut end were similar. The histological findings of the pancreatic capsule and parenchyma after the compression by staple jaws without firing also were similar.

Conclusions

RC may provide an advantage as measured by pressure tolerance. A small series of distal pancreatectomy with a stapler that compares the speed of different stapler jaw closing times is required to prove the feasibility of these results after the confirmation of the advantages of the RC method under various settings.