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Tissue compression

Compression prepares the tissue for stapling.

As the bowel is compressed, two important functions occur:

  1. Fluid flows out of the area of compression
  2. Tissue pressure reduces over time

The graph below shows the impact of compression by stapler arms on tissue thickness of the bowel. No addition benefit is provided by prolonged compression beyond 15 seconds, but the risk of tissue ischemia is increased.

 

The following series of diagrams demonstrate the principles of tissue compression during stapling. Adequate compression ensures that staples are secured correctly, and are able to maintain the integrity of the anastomosis.

 

Key message: Stapler manufacturers recommend a 15 second pause after compression jaw closure before using firing the stapler

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