Surgical Staplers Flashcards
You should not use staples in the ______ b/c they would transect all circular muscle fibers
Small colon
High risk of impaction and dehiscence if you use staples at this site
Small colon
Do staples or sutures have higher bursting pressure?
Sutures
2 staggered rows of B-shaped staples to seal tissues and vessels
Thoracoabdominal stapler
Everts the mucosa which could lead to abscessation and more adhesions
TA stapler
Why is oversewing a TA stapled incision not an option?
Abscess formation
Which stapler is better than a TA stapler if there is enough healthy tissue/
Parker-Kerr
Used to close hollow viscera stumps and can be sewn over
Parker-Kerr stapler
What suture pattern do you use over a Parker-Kerr staple line?
Cushing with stapler in place
Lembert after stapler removed
Rank the bursting pressure of handsewn, skin stapler, and TA 90 for closure of a PF enterotomy
HS > skin stapler > TA-90
Rank the cost of handsewn, skin stapler, and TA 90 for closure of a PF enterotomy
TA-90 > skin stapler > HS
What carries a higher risk of abscessation?
Eversion of mucosa
GIA
Gi anastomosis stapler
ILA
Intestinal linear astamosis stapler
What anastamoses are GIA and ILA used for?
Side-to-side
4 staggered rows of B-shaped stables w/cutting blade to divide tissue between 2nd and 3rd rows
GI staplers
When are GIA and ILA (side-to-side) anastamosis techniques used?
Jejunocecostomy or large colon
What kind of anastamosis do we do for small intestine?
End-to-end
What GI stapler is used for laparoscopic procedures?
Endo-GIA
Reduces tissue thickness and makes closure of a GIA staple more effective
Pre-compression
What is GIA pre-compression?
15 sec interval between closing the GIA and firing the staples
What is the more common metal used for staples?
Titanium (also use stainless steel)
What color cartridge is used to indicate large size staples?
Green
What color cartridge is used to indicate small size staples?
Blue
What is the advantage of a B-shaped staple?
Allows blood flow (doesn’t crush tissues flat)
Places 2 vascular staples and cuts between them
LDS
LDS
Ligating dividing stapler
Tissue must be compressed to _____ to use an LDS
0.75mm
Mainly used in horses for rapid obstruction of mesenteric vessels during SI resection and anastamosis
LDS
One suture ligation is required alongside this stapling technique
LDS
When using ligating clips, what should the lumen of the vessel be relative to clip size?
1/3 to 2/3 the size of the clip
More easily dislodged than suture ligations and are not commonly used b/c of the better options available
Ligating lips
rapid closure of surgical incisions w/o tensions
Skin staplers
Provide excellent wound edge eversion
Skin staplers
How far apart are skin staples applied for an SI anastomosis?
1-2mm
What is a risk of using skin sutures for an SI anastamosis?
Rigidity of staple = risk of serosal tearing
How much faster is closing an SI anastamosis with staples than with suture?
3x faster
Causes inversion (desirable) of an PF enterotomy (better than TA-90)
Skin stapler
What is the difference in bursting pressure between sutures and skin staples used for typhlotomy in cattle?
None
