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A Better Way to Staple
Surgical Staplers
A Better Way to Staple
Surgical Staplers
Surgical stapling complications can have a major impact on clinical outcomes and an increased financial burden for healthcare systems. Our tissue-specific open and laparoscopic stapler designs are based on science and backed by a growing body of real-world evidence and have been associated with improved outcomes and reduced financial burden.1
Performance-Driven Results, Backed by Evidence
Since 2017, the use of ECHELON™ Powered Staplers has demonstrated an association with improved clinical and economic outcomes—across tissue types, patient populations and countries—in bariatric, thoracic and colorectal procedures.1

Clinical Evidence
Today’s patient enters the operating room with comorbidities that increase factors of surgical risk—like heart disease, obesity, diabetes and more. Providing a stapling technology that accounts for both challenging anatomy and complex procedures is critical in managing complications. Our line of surgical staplers can help decrease the burden of clinical complications.

Economic Evidence
Ethicon stapling solutions reduce complications1 - supporting higher efficiency in the operating room and reducing hospital costs. ECHELON™ Powered Staplers have been associated with lower hospital costs in bariatric and colorectal surgery.2,3
The Impact of Surgical Stapling Complications

Bariatric Bleeding
Postoperative bleeding can cause surgical complications that lead to substantial morbidity and incremental hospital costs of $6,715–$7,500.4,5

Thoracic Air Leaks
Postoperative air leaks occur in up to 24% of lobectomies and may lead to a higher risk of in-hospital mortality and incremental hospital costs of $6,500.6

Colorectal Leaks
Postoperative anastomotic leaks occur in up to 12% of colorectal resections with mortality reported between 12% and 27%,7 and costs of around $17.8k per leak.8

Reduce Bleeding Complications
ECHELON™ Powered Staplers have been associated with:
- 73% (0.61% vs. 2.24%) reduction in bleeding complications vs. Medtronic powered staplers in bariatric laparoscopic sleeve gastrectomy9
- 47% (1.61% vs. 3.05%) lower rate of bleeding complications vs. Medtronic manual staplers in bariatric laparoscopic procedures10
- 66% (4.8% vs. 14.2%) lower rate of bleeding complications vs. Medtronic manual staplers in thoracic VATS lobectomy11

Address Leaks
ECHELON™ Powered Staplers have been associated with:
- 85% reduced anastomotic leaks vs. manual circular staplers in left-sided colorectal surgery12
- 2x fewer staple line air leaks vs. Medtronic manual staplers in physiologic lung model13

Accommodate Tissue Variability
ECHELON™ Gripping Surface Technology (GST) Reloads and ECHELON ENDOPATH™ Staple Line Reinforcement (SLR) offer an unparalleled flexibility to match the unique tissue of the patient and procedure.
- Match unique tissue thicknesses with five custom reload options
- Enable seamless tissue manipulation with proprietary buttress attachment material14
- Designed with unifiorm staple heights for consistent compression
References
1. Rawlins L, Johnson BH, Johnston SS, et al. Comparative Effectiveness Assessment of Two Powered Surgical Stapling Platforms in Laparoscopic Sleeve Gastrectomy: A Retrospective Matched Study. Medical Devices: Evidence and Research. 2020:13 195–204. doi: https://doi.org/10.2147/MDER.S256237. Miller DL, Roy S, Kassis ES, et al. Impact of Powered and Tissue-Specific Endoscopic Stapling Technology on Clinical and Economic Outcomes of Video-Assisted Thoracic Surgery Lobectomy Procedures: A Retrospective, Observational Study. Adv Ther. 2018 Apr 16. doi: 10.1007/s12325-018-0679-z. Sylla P, Sagar P, Johnston S, et al. Outcomes associated with the use of a new powered circular stapler for left-sided colorectal reconstructions: a propensity score matching-adjusted indirect comparison with manual circular staplers. Surgical Endoscopy. 2021. doi: 10.1007/s00464-021-08542-7. (192176-211013)
2. Rawlins L, Johnson BH, Johnston SS, et al. Comparative Effectiveness Assessment of Two Powered Surgical Stapling Platforms in Laparoscopic Sleeve Gastrectomy: A Retrospective Matched Study. Medical Devices: Evidence and Research. 2020:13 195–204. doi: https://doi.org/10.2147/MDER.S256237.
3. Pollack E, Johnston S, Petraiuolo W, et. al. Economic analysis of leak complications in anastomoses performed with powered versus manual circular staplers in left-sided colorectal resections: a U.S.-based cost analysis. ClinicoEconomics and Outcomes Research 2021;13:531-40
4. Daigle, C.R. et al, “Which postoperative complications matter most after bariatric surgery? Prioritizing quality improvement efforts to improve national outcomes”, Surgery for Obesity and Related Diseases, (2018) 14:652-757
5. Based on Ethicon (2018) internal analysis from procedure data from 63,731 Roux-en-Y gastric bypass procedures captured in Premier Perspective database.
6. Yoo A, et al. Burden of air leak complications in thoracic surgery estimated using a national hospital billing database. ClinicoEconomics Outcomes Res.2017;9:373-383.
7. Koianka T, Kevin M. Martin W, et al. Identifying Important Predictors for Anastomotic Leak After Colon and Rectal Resection. Annals of Surgery. 2013; 257:108.
8. Truven Commercial and Medicare, USA Colorectal Complication Rates 2010-2015.
9. Rawlins L, Johnson BH, Johnston SS, et al. Comparative Effectiveness Assessment of Two Powered Surgical Stapling Platforms in Laparoscopic Sleeve Gastrectomy: A Retrospective Matched Study. Medical Devices: Evidence and Research. 2020:13 195–204. doi: https://doi.org/10.2147/MDER.S256237. Analysis of hemostasis-related complication outcomes from 982 laparoscopic sleeve gastrectomy cases between March 1, 2017 and December 31, 2018 from Premier Healthcare Database (0.61% versus 2.24%, p=0.0012). (140345-200514)
10. Use of Ethicon powered staplers was associated with fewer bleeding/transfusion complications (1.61%) compared to Medtronic non-powered staplers (3.05%), p=0.010, in laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass procedures. Based on retrospective analysis of 21,466 cases from the Premier Perspective® Hospital Database. (133986-200304)
11. Miller DL, et al. Impact of powered and tissue-specific endoscopic stapling technology on clinical and economic outcomes of video-assisted thoracic surgery lobectomy procedures: a retrospective, observational study. Review of 1,051 cases between 2015 and 2016 from the Premier Healthcare Database (4.8% vs 14.2%; p=0.010). (084009-180619)
12. Impact of the Novel Powered Circular Stapler on Risk of Anastomotic Leakage in Colorectal Anastomosis. A Propensity Score-Matched Study. [ECHELON CIRCULAR 1.7% (1/60) vs. manual circular 11.8% (14/119), p=0.022]. (153162‐200916)
13. Staple line air leaks in porcine lungs using a physiologically-based ex-vivo lung chamber model. ECHELON FLEX™ GST System vs Endo GIA™ with Tri-Staple™ Technology. 20% vs 44%, GST 45 Blue (n=25) & Green (n=30) reloads vs Tri-Staple™ 45 Purple (n=25) & Black (n=30). Based on similar design features between ECHELON GST45 & GST60, no significant difference in performance is expected. (085127-201203)
14. Based on coverage after manipulation assessment on porcine tissue.
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