Remedy Publications LLC., | http://surgeryresearchjournal.com World Journal of Surgery and Surgical Research 2021 | Volume 4 | Article 1292 1 Advances in the Design of a Curved Cutter Stapler for Colorectal Surgical Procedures OPEN ACCESS *Correspondence: Paula Veldhuis, Medical Affairs, Ethicon Inc., a Johnson and Johnson Company, 4545 Creek Road, Cincinnati, OH 45242, USA, E-mail: PVeldhui@its.jnj.com Received Date: 11 Feb 2021 Accepted Date: 09 Mar 2021 Published Date: 12 Mar 2021 Citation: Posey RP, Paulin-Curlee G, Henninger DD, Jones S, Clymer JW, Veldhuis P. Advances in the Design of a Curved Cutter Stapler for Colorectal Surgical Procedures. World J Surg Surgical Res. 2021; 4: 1292. Copyright © 2021 Paula Veldhuis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Research Article Published: 12 Mar, 2021 Abst ract Background: In colorectal procedures, including Low Anterior Resection (LAR), surgeons have found it benefcial to use a stapler designed to provide access in the deep pelvis such as the CONTOUR® Curved Cutter Stapler (CCS). A new version of this stapler, the ECHELON CONTOUR® Curved Cutter Stapler (ECCS) has been developed, featuring Gripping Surface Technology (GST) and Tree-Dimensional (3D) staples. Tis study was undertaken to evaluate the ECCS in comparison to the previous version and another commercially-available stapler. Methods: ECCS was compared to CCS for post-compression tissue trauma, both visually and via histological analysis, and post-stapling tissue healing response at 7- and 21-days post-surgery. ECCS was compared to the ENDO GIA Stapler (GIA) for leak onset pressure along the staple line. Results: ECCS exhibited signifcantly less gross visible tissue trauma following compression than the predicate device (p<0.001). Histological examination indicated similar tissue trauma and tissue healing response for ECCS and CCS. In leak onset pressure testing, ECCS provided a 30.8% higher mean pressure than GIA (p=0.002), and a 55% lower leak rate at 30 mmHg (p=0.011). Conclusion: To gain the benefts of hybrid laparoscopic colorectal techniques, the narrow head design of the CCS is particularly useful in accessing the deep pelvis. Te new ECCS incorporates GST for enhanced tissue handling without any negative efect on tissue trauma or healing response. Additionally, ECCS uses 3D stapling technology which provides signifcantly stronger sealing. Together these technical advances make ECHELON CONTOUR® Curved Cutter Stapler the new standard in colorectal procedures. Keywords: Curved cutter stapler; Contour; Colorectal; Echelon; Low rectum; Pelvic access; Low anterior resection Ryan P Posey, Geisa Paulin-Curlee, Dwight D Henninger, Shannon Jones, Jeffrey W Clymer and Paula Veldhuis* Medical Affairs, Ethicon Inc, Cincinnati, OH, USA Introduction Surgical staplers have been successfully used for over a century and during the intervening interval, the technology has progressed substantially [1]. Te CONTOUR ® Curved Cutter Stapler, a device which both cuts and staples, has been widely utilized in the past decade initially in open and more recently in hybrid laparoscopic colon and rectal surgical procedures [2-6]. Te CONTOUR ® Curved Cutter Stapler is a 4-row stapler designed with a small curved head for deep pelvic access. It is specifcally useful in the narrow male pelvis where technical challenges exist associated with transecting the rectum while obtaining sufcient margins in decreased working space, including during Low Anterior Resection (LAR) [7]. In addition to its unique curved head, the stapler has a tissue retaining pin, which may be used to prevent slippage of the tissue from the jaws of the device. Te knife extends to the retaining pin and the staple line extends beyond the pin, supporting multiple frings with a reloadable cartridge when needed to complete a single transection. Even with past technical advances, sub-optimal tissue handling may produce inadvertent tissue injury leading to diminished perfusion, hindered healing and increased risk of Anastomotic Leaks (AL) [8] which is a dreaded and potentially deadly complication. AL is associated with peritonitis, sepsis, anastomotic dehiscence, abscess, fecal incontinence, reoperation, increased length of stay, and death [9-12]. Incidence rates vary from 0% to 36% in low anterior resection with clinically signifcant AL described between 10% to 14% [9,13]. Building upon the technology of the CONTOUR ® Curved Cutter Stapler device, a next generation device, the ECHELON CONTOUR™ Curved Cutter Stapler, has been developed which introduces