The MicroCutter 5/80 stapler, the world’s smallest profile articulating surgical stapler, continues to enable the advancement of minimally invasive surgeries worldwide with a first-of-its kind use in a laparoscopic duodenal atresia repair in a newborn. Leading pediatric surgeon Oliver Muensterer, M.D., Ph.D., Professor and Chairman of Pediatric Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, performed the challenging laparoscopic repair, known as duodenoduodenostomy, earlier this month. During the procedure, Dr. Muensterer used the MicroCutter 5/80 stapler as an alternative to hand sewn anastomosis.
Duodenal atresia is a birth defect that occurs when there is a narrowing or blockage of the first part of the small bowel, also known as the duodendum, where the intestine ends blindly. Surgery is needed to reconnect the two parts of the duodenum to reestablish normal flow of nutrients, often within the first few days of life.
Laparoscopic surgery for duodenal atresia repair is technically challenging for surgeons to perform, especially in neonates, due to the small space available for suturing of the anastomosis (i.e., the rejoining of the two tubular ends of the duodenum to bypass the blockage). While extensive clinical literature shows that a stapled anastomosis produces better outcomes than hand sewn bowel anastomosis, including lower leak rates, less stricture and reduced infections, the small abdominal space in a newborn makes it virtually impossible to perform anastomosis laparoscopically using a conventional surgical stapler.
In addition to potential differences in outcomes, hand sewn anastomosis takes much longer to complete, which can place additional stress on the tiny patient. In this case, Dr. Muensterer was able to perform the anastomosis procedure effectively with the use of the MicroCutter 5/80 stapler, which has a shaft diameter of only 5 mm (vs. 12mm for most conventional staplers) and provides 80 degrees of articulation.
“The small size of the MicroCutter made it possible to use a stapler in this tiny patient. It also reduced operating time significantly, which is especially important in newborns,” Dr. Muensterer says. “The MicroCutter makes this procedure easier to perform laparoscopically by eliminating the need for a hand sewn anastomosis, and may accelerate the adoption of minimally invasive techniques for pediatric patients.”
“Challenging cases such as this show how the small size and wider articulation of the MicroCutter stapling technology can enable more minimally invasive procedures for both pediatric and adult patients,” says Julian Nikolchev, president and CEO of Dextera Surgical. “We are proud of the positive impact the MicroCutter is having in procedures that have previously been limited by the tight spaces in which surgeons have to operate.”