Powered Stapling Platforms in Laparoscopic Liver Resection

Max Shapiro¹, Michael Darden², David Sigmon¹, Emad Kandil¹, Chris Ducoin¹, Adam Hauch¹, Geoffrey Parker³ and Joseph F Buell¹*

Received: September 22, 2017   Published: October 06, 2017

DOI: 10.26717/BJSTR.2017.01.000416

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Abstract

Introduction: The most recent innovation in laparoscopic surgery has been the introduction of powered stapler platforms. These systems were designed to standardize staple formation, by minimizing tissue dissection and controlling tissue compression and staple formation.

Methods: Retrospective cohort analysis compared laparoscopic powered E-beam stapler platform to a laparoscopic non-powered I-beam stapler. The analysis was performed using a robust 2:1 control group study. Statistical analysis was performed using STATA.

Results: Forty-three powered cantilever E-beam stapler resection cases were compared to 86 cases of non-powered I-beam stapler resections. Both cohorts were equally matched for demographics, extent of liver disease, tumor size and type of resection. The non-powered I-beam group did have a higher ASA score (2.8 vs. 2.6; p<0.037). Staple usage, blood loss, and complication rates were equivalent. Operative time was significantly shorter in the powered stapler group (136 vs. 157 hrs; p=0.026) realizing accumulative 90-day global cost savings of $8,248.89 per case (p=0.012).

Conclusion: Laparoscopic powered E-beam stapler platforms appear to be safe and efficacious with equivalent performance and complication profiles compared to non-powered I-beam platforms. Powered stapling platforms also appear to minimize parenchymal injury reducing operative time further decreasing disposable and global costs.

Keywords : Liver Resection; Stapler Hepatectomy; Powered Stapler Platforms

Abstract| Introduction| Materials and Methods| Results| Discussion| Conclusion| References|