The development of tissue stapling devices has led to many advancements in the field of bariatric surgery. Stapling devices has made it possible to perform all types of bariatric procedures by laparoscopic technique. Previously, complex operations of the abdomen including bariatric surgeries were performed by open technique which necessitated giving a big cut on the abdomen and performing the operation manually by cutting with scissors and putting stitches on the stomach and intestines to seal the tissues. Nowadays, the stapling devices make all of these possible by keyhole surgery and the entire process has become mechanised.
The stapler cartridge has 3 rows of very small stapling pins on either side of a groove in which a blade moves for cutting the tissue. Thus, when a cartridge is loaded on a stapling gun and applied onto a tissue, the tissue is stapled and sealed on both sides and cut in between. Repeated firing of the stapler thus enables us to create a pouch or sleeve shape of the stomach and also to create new joints between the stomach and small intestine. The process is fast, efficient and bloodless which helps to reduce the surgical time and also the risk of complications. Since the staples are applied in three rows, there is a triple layer of safety which helps to guard against bleeding and leakage of contents after the surgery. The stapler pins are made up of titanium and they are designed to remain inside the body for the entire lifetime. They become integrated into the tissues without causing any side effects in the long term.
Modern stapling devices have added many features to increase the safety and efficiency of the surgery. Some stapler companies have come up with a powered stapling gun which fires the stapler pins upon pressing a single button. This decreased the movement during application of the stapler pins and creates a uniform stapler line. Others have developed cartridges which have stapler pins of staggered heights in the three rows to ensure that tissues of variable thickness are properly sealed during application of the stapler and thus decrease the chances of leakage. Recently, a fully automated stapling gun has also been developed which can calculate the thickness of tissue and then ensure the application of the required stapler cartridge.
Thus, the future of bariatric surgery appears bright because of advancements in stapling technology which will continue to increase the safety of these procedures.