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Endoscopic Staplers

Staplers are useful to staple tissue with many of the endoscopic applicators being able to also transect tissue between the pre-placed clips. An excellent use is for either lung biopsies or for lung resections of tumors.

Several companies have staplers, all of which are disposable and can be used with a variety of clip sizes. Some have the capability to be rotated and “bent” within the body cavity.

Above: This Covidien 10 stapler/divider has a handle that can be re-used during the procedure by adding another tip that is pre-loaded with staples. This has the advantage of being able to “bend” the stapler applicator once inside the body cavity. This can be very useful when attempting to place the row of clips perpendicular to the long axis of the tissue being amputated. A 30-degree scope is very helpful to exam the tissue with the intended site of stapling.

Above: Staple units come in a variety of sizes. In general, we select a length that is definitely long enough and try to avoid using multiple staple units when doing an amputation. Three rows of staples are placed before a cutting blade is used to sever the tissue. When applying staples to lungs, the lung should not be inflated during the stapling procedure. An air-tight seal should be confirmed after removal of the lung tissue.

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