If you look at a desktop stapler, you will see that it is formed by very simple components: a staple, a pushing element, and an anvil that helps form the staple. This simple device has revolutionized surgery allowing surgeons to perform complex anastomoses and resections that otherwise could take a long time using sutures.
The story of surgical stapling starts with surgeons that established the parameters for a safe and leak-proof anastomosis as well as the tenets of antisepsis.
Christian Albert Theodor Billroth (1829 – 1894) set the parameters for gastrointestinal anastomoses when he developed the “Billroth I” and “Billroth II” procedures.
William S. Halsted (1852 – 1922), who started modern American medical education, set the “rules” for a good anastomosis and tissue management. Halsted preached for the use of small-gage sutures and needles, good surgical technique, and reduction of tissue trauma. Halsted proved empirically that a single-layered anastomotic suture worked as well as a double-layered suture line. Surgical staplers apply a single layer of staples.
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Pioneers of Surgical Stapling
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In 1910 Halsted developed a non-suture anastomotic device, but it never went beyond the prototype stage.
The search for a safe end-to-end anastomosis led to the development of the “Murphy button” by Dr. John Benjamin Murphy (1857 – 1916) a “sutureless compression anastomotic device” in 1982, the precursor of some modern compression anastomotic devices, such as those developed by Novo GI (ex NiTi Surgical).
Continued....
The history of surgical stapling [1] ; [2]; [3]; [Video]
Sources 1. "Surgical stapling" Mallina, R F 1962 Scientific American 207, 48 2. “Science of Stapling: Urban Legend and Fact” Pfiedler & Ethicon EndoSurgery 3. “Cholecystointestinal, gastrointestinal, enterintestinal anastomosis, and approximation without sutures” Murphy JB. Med Rec (1892) 42: 665 4. “Study of Tissue Compression Processes in Suturing Devices” Astafiev, G. (1967 (USSR Ministry of Health, Ed.) 5. “Rese?as Hist?ricas: John Benjamin Murphy” Parquet, R.A. Acta Gastroenterol Latinoam 2010;40:97. 6. “The Science of Stapling and Leaks” Baker, R. S., & et al. (2004) Obesity Surgery, 14, 1290-1298. 7. “John Benjamin Murphy – Pioneer of gastrointestinal anastomosis”Bhattacharya, K., & Bhattacharya, N. (2008). Indian J. Surg., 70, 330-333. 8. “The Story of Surgery” Graham, H. (1939) New York: Doubleday, Doran & Co.. Inc. 9. “Compression Anastomosis: History and Clinical Considerations”Kaidar-Person, O, et al, e. (2008) Am J Surg, 818-826. 10. “Current Practice of Surgical Stapling”Ravitch, M. M., Steichen, F. M., & Welter, R. (1991) Philadelphia: Lea& Febiger. 11. “Aladar Petz (1888-1956) and his world-renowned invention: The gastric stapler” Olah, A. Dig Surg 2002: 19; 393-3
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