DevelopmentsSurgery

This Pediatric Surgical Stapler Reducing Port Size from 12mm to 5mm

5mm Trochar Size Fit Tiny Surgical Stapler Use in Laparoscopic Appendectomy

The JustRight 5mm Stapler delivers innovation 40 years in the making. This new 5mm Stapler is optimized for pediatric patients and lessens the impact of surgery by replacing oversized, overpowered instruments in the most delicate patients. JustRight stapler was founded to combat the unmet need of the lack of correctly sized devices for use in pediatric laparoscopic and thoracoscopic surgery.

This universal stapler is specifically designed and tested for the pediatric population. It is correctly sized for use in pediatric laparoscopic and thoracoscopic surgery.

The reduced instrument shaft diameter and optimized jaw length are 9 times smaller than existing stapling instruments. This increases maneuverability and visualization in small spaces and enables flexibility in stapler port placement.

The JustRight 5mm Stapler delivers the security of the gold standard B staple formation and features smooth and efficient stapling and cutting in a single, one-handed motion.

Stapler can be reloaded for multiple uses within a single procedure. The simple 3 step process allows the user to quickly and easily replace a spent staple cartridge.

Surgeons can downsize ports to 5 mm from 12 mm required for all other manual surgical staplers. This leads to procedural time savings due to elimination of the need to close fascia on a 5 mm incision.

The JustRight 5mm stapler can be moved from port to port without the need to upsize, simplifying workflow and enabling versatility of port placement.

  • Provides secure sealing Classic B formation of 2.0 mm titanium staples in 4 rows of 6 staggered staples provides secure staple line.
  • When deployed it leaves 2 rows of 2mm B-shaped staples with a staple length of 2.5cm.
  • The stapler allows for 360 degrees of jaw rotation.
  • Improves access, maneuverability and visualization in tight surgical cavities.

The Use of a 5mm Endoscopic Stapler in Laparoscopic Appendectomy

Appendectomy is the most common surgical emergency. In order to mitigate high operating room charges associated with longer surgeries, many surgeons use endoscopic staplers to divide the appendix base and, sometimes, the mesoappendix.

Traditionally this requires a larger 10mm port to accommodate the endoscopic stapler, increasing the risk of port-site complications, such as hernia, and post-operative pain, which impedes same-day discharge in otherwise eligible patients.

The JustRight 5mm endoscopic stapler is designed for the small working space encountered in pediatric minimally invasive surgery.  In this case series, the JustRight 5mm stapler in was used to limit port size in patients undergoing emergency laparoscopic appendectomy.

Persistent bleeding from the stump staple line required application of a hemostatic maneuver in very very rare stuation. The JustRight 5mm stapler was used to additionally divide the mesoappendix without complication.

There were no staple misfires and no recorded cases of staple-line leak in one series. The median operating time is significantly reduce.In the same series there was one re-admission with a pelvic abscess in a patient who had been managed as uncomplicated appendicitis.

The JustRight 5mm stapler can be employed safely for laparoscopic appendectomy in patients regardless of age or size, with potentially beneficial effects on post-operative analgesia requirements and hospital stay, and avoiding the need for 10mm port-sites. Successful use is determined by the size of the appendix base.

The Use of a 5mm Endoscopic Stapler in Bowel Anastomosis

The use of staplers to perform gastrointestinal anastomoses has been standard practice for adults for many years. However, there has been much less widespread use in pediatric populations. In neonates and infants, use of both endoscopic and open linear staplers has been reported with documented short-term success.

However, one of the primary limitations to more widespread use of staplers on neonatal bowel was the large size of the jaws of the stapler relative to the bowel lumen. The JustRight 5mm linear endoscopic stapler has a 5mm shaft diameter and 2mm staple height.

Most significantly, the stapler jaws are markedly smaller than those found on both open and endoscopic staplers currently available.

The 5 mm laparoscopic stapler offers an attractive alternative in hand sewn open neonatal intestinal anastomosis, particularly in both ease and time of anastomosis. The stapler is faster and creates a larger diameter anastomosis.

Primary References

  1. The use of a 5mm endoscopic stapler in laparoscopic appendectomy. David Coyle, SAGES 2017 Annual Meeting in Houston, TX. Emerging Technology Poster Session
  2. Use of 5-mm Laparoscopic Stapler to Perform Open Small Bowel Anastomosis in a Neonatal Animal Model. Ian C Glenn et al. J Laparoendosc Adv Surg Tech A. 2016 Oct;26(10):840-844.
  3. Neonatal Intestinal Anastomosis Using a 5 mm Laparoscopic Stapler. Casey T Walk et al. J Laparoendosc Adv Surg Tech A. 2019 Apr;29(4):579-581.

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