Stapler History Humer Hultl: the father of the surgical stapler Journal of medical biography 2001; 9: 16-19 Aladar Petz and his world-renowned invention: the gastric stapler ِDigestive surgery 2002; 19:393-399

Staplers used to reduce the gasterectomy complications Prevent spillage of gastric and intestinal content in to the peritoneal cavity Reduce risk of peritonitis Reduce time of surgery and anesthesia Reduce mortality

Dr. Humer Hultl Hungarian surgeon (1868-1940) Chief surgeon at Stephen’s hospital, Budapest. Durin World War 1 he was commandar of a military hospital. He was among the first to use: tincture of iodine for skin preparation. face mask sterile cotton “The surgeon should strive to decrease the number of microorganisms entering the operating wound to the minimum“

In 1907 the idea occurred to him: place rows of metal staples into the wall of the hollow organ before its division. there were two sizes: 17 cm long to close the cardia 11 cm to staple the duodenum The device suturing with a fine wire hook. suture the stomach in four parallel lines . surgeon had to cut between the clips after closing the margin of the incision. after dividing the stomach he covers the suture line with Lembert peritoneal stitches

Fischer-Hultl instrument had several drawbacks: It was heavy (more than 3.5 Kg) It has complex structure (consists of 12 moving parts) It was difficult to clean It was time-wasting to refilling the clips Only 50 of them put in to use.

Aladar Petz Inventor of stapler Hungrian surgeon (1888-1956) Military surgeon in world war 1 Modern surgical staplers are based on Petz’s original design

Petz’s Instrument was: lighter easier to handle Uses Nickel Silver instead of wires Used double-clip system It was possible for the operating nurse to recharge the instrument

The first stapling instrument Dr The first stapling instrument Dr. Rovitch brought home from the Soviet Union

Skin Stapler

Fascia Stapler

Circular Stapler places a circular, double staggered row of titanium staples. The instrument is activated by squeezing the handles firmly as far as they will go. Immediately after staple formation, the knife blade resects the excess tissue, creating a circular anastomosis.

Circular Stapler Provides flexibility and improved access in procedures where the extra length is a benefit (Gastric Bypass).

Linear Stapler Single Use Stapler with Absorbable Staples places two, double staggered rows of Lactomer™ absorbable copolymer staples and simultaneously divides the tissue between the two, double rows.

Linear Stapler with directional staple technology

Endocutter

Prolapse and Hemorrhoidal Circular Stapler Procedure for Prolapse and Hemorrhoids (PPH). PPH has a unique advantage over conventional techniques because the procedure is performed above the dentate line inside the anal canal, affecting fewer nerve endings. Our PPH device provides two staggered rows of titanium staples in 33mm diameter size applied in the anal canal for transection and resection of internal tissue

Good Luck