Surgical Stapling: Principles and Precautions

  • Jameson L. Chassin


Preserving the viability of the tissues distal to the line of staples is basic to the concept underlying the use of staples to perform a surgical anastomosis. The flow of blood penetrates the double staggered rows of staples that have been applied to the tissues. Unless the tissues are much too thick to be suitable for stapling, one will notice blood oozing through the staple line because the staples assume the configuration of a B when they are fired. Consequently, there is tissue along the staple line that completely escapes being enclosed by the staples, permitting the passage of blood to and beyond the stapled anastomosis. If the tissues being stapled are so thick that compression by the stapling device is likely to produce necrosis, this technique is contraindicated. On the other hand, if the tissues are so thin that the staples cannot provide a firm approximation, bleeding and anastomotic leakage may occur.


Staple Line Staple Anastomosis Enterocutaneous Fistula Anastomotic Healing Anastomotic Complication 
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Copyright information

© Springer-Verlag New York Inc. 1980

Authors and Affiliations

  • Jameson L. Chassin
    • 1
    • 2
    • 3
    • 4
    • 5
  1. 1.School of MedicineNew York UniversityUSA
  2. 2.University Hospital, New York University Medical CenterUSA
  3. 3.New York Veterans Administration HospitalUSA
  4. 4.Bellevue HospitalUSA
  5. 5.Long Island Jewish-Hillside Medical CenterUSA

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