Safety and Feasibility of a Lower-Cost Stapler in Bariatric Surgery

Kurt E. Roberts, Lisa Renee Hilton, Danielle T. Friedman, Joel S. Frieder, Xuchen Zhang, Andrew J. Duffy

Research output: Contribution to journalArticle

Abstract

Background: Laparoscopic staplers are integral to bariatric surgery. Their pricing significantly impacts the overall cost of procedures. An independent device company has designed a stapler handle and single-use reloads for cross-compatibility and equivalency with existing manufacturers, at a lower cost. Objectives: We aim to demonstrate non-inferior function and cross-compatibility of a newly introduced stapler handle and reloads compared to our institution’s current stapling system in a large animal survival study. Setting: University-affiliated animal research facility, USA. Methods: Matched small bowel anastomoses were created in four pigs, one with each stapler (a total of two per animal). After 14 days, investigators blinded to stapler type evaluated the anastomoses grossly and microscopically. Each anastomosis was scored on multiple measures of healing. Individual parameters were added for a global “healing score.” Results: Clinical stapler function and gross quality of anastomoses were similar between stapler groups. Individual scores for anastomotic ulceration, reepithelialization, granulation tissue, mural healing, eosinophilic infiltration, serosal inflammation, and microscopic adherences were also statistically similar. The mean “healing scores” were equal. While this study was underpowered for subtle differences, safe and reliable performance in large animals still supports the feasibility of introducing new devices into human use. Conclusions: The new stapler system delivers a similar technical performance and is cross-compatible with currently marketed stapling devices. An equivalent quality device at a lower price point should enable case cost reduction, helping to maintain hospital case margin and procedure value in the face of potentially declining reimbursement. This device may provide a safe and functional alternative to currently used laparoscopic surgical staplers.

Original languageEnglish (US)
Pages (from-to)401-405
Number of pages5
JournalObesity Surgery
Volume29
Issue number2
DOIs
StatePublished - Feb 15 2019

Fingerprint

Bariatric Surgery
Safety
Costs and Cost Analysis
Equipment and Supplies
Surgical Staplers
Granulation Tissue
Swine
Research Personnel
Inflammation

Keywords

  • Bariatric surgery
  • New technology
  • Surgical devices
  • Value

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Roberts, K. E., Hilton, L. R., Friedman, D. T., Frieder, J. S., Zhang, X., & Duffy, A. J. (2019). Safety and Feasibility of a Lower-Cost Stapler in Bariatric Surgery. Obesity Surgery, 29(2), 401-405. https://doi.org/10.1007/s11695-018-3580-6

Safety and Feasibility of a Lower-Cost Stapler in Bariatric Surgery. / Roberts, Kurt E.; Hilton, Lisa Renee; Friedman, Danielle T.; Frieder, Joel S.; Zhang, Xuchen; Duffy, Andrew J.

In: Obesity Surgery, Vol. 29, No. 2, 15.02.2019, p. 401-405.

Research output: Contribution to journalArticle

Roberts, KE, Hilton, LR, Friedman, DT, Frieder, JS, Zhang, X & Duffy, AJ 2019, 'Safety and Feasibility of a Lower-Cost Stapler in Bariatric Surgery', Obesity Surgery, vol. 29, no. 2, pp. 401-405. https://doi.org/10.1007/s11695-018-3580-6
Roberts, Kurt E. ; Hilton, Lisa Renee ; Friedman, Danielle T. ; Frieder, Joel S. ; Zhang, Xuchen ; Duffy, Andrew J. / Safety and Feasibility of a Lower-Cost Stapler in Bariatric Surgery. In: Obesity Surgery. 2019 ; Vol. 29, No. 2. pp. 401-405.
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