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Статті в журналах з теми "Stapler"

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Contini, Elizabeth, Marisha L. Godek, Jennifer M. Whiffen, and Dwight G. Bronson. "Ex Vivo Pneumostasis Evaluation of a Variable-Height Staple Design." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 8, no. 4 (June 2013): 284–88. http://dx.doi.org/10.1097/imi.0b013e3182a6912a.

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Objective This study examined the effect of using a variable-height staple construct containing three rows of staples with heights of 3.0, 3.5, and 4.0 mm (staple leg length, medial to lateral) versus standard three-row single-height staplers (with staple heights of either 3.5 or 4.8 mm) for pneumostasis in healthy porcine and canine lung parenchyma to determine whether a single stapler that uses variable staple heights could perform as well as, or better than, existing single-height stapling devices. The work presented here used healthy animal tissues, in lieu of diseased tissue, which is extremely difficult to obtain and quantify. Methods Briefly, fresh explanted porcine and canine trachea-lung blocs were used for all testing. Tissue thicknesses were measured with a custom-design spring-loaded caliper before stapling with control and test articles to ensure that the tissue was of “appropriate” thickness for the stapler size (staple height) selected (per manufacturer's instructions for use). All tissue measurements were comparable across each area of lung tested, and both test and control devices were fired into the same tissue thicknesses. After stapling, the lungs were submerged in water, insufflated, checked for air leaks at four discrete (increasing) pressures, and scored using a predetermined scale. Statistical analysis was performed for n = 26 (3.5-mm staples), n = 29 (4.8-mm staples), and n = 26 or 29 (paired to the standard group) for the variable-height stapler (3.0-, 3.5-, and 4.0-mm staples). Results The results demonstrated that the test article comprising three rows of variable-height staples provided comparable pneumostasis with the standard three-row single-height staplers (with staple heights of either 3.5 or 4.8 mm) under the test conditions described. Conclusions A novel test article containing three rows of staples with heights of 3.0, 3.5, and 4.0 mm (variable-height stapler) showed promising results when compared with standard commercially available single-height staplers, performing as well as or better than the standard single-height staplers. This work demonstrates important first steps to proving equivalent device performance, which might facilitate the use of a variable-height stapler in place of multiple single-height staplers.
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Richtsmeier, William J. "Myotomy Length Determinants in Endoscopic Staple-Assisted Esophagodiverticulostomy for Small Zenker's Diverticula." Annals of Otology, Rhinology & Laryngology 114, no. 5 (May 2005): 341–46. http://dx.doi.org/10.1177/000348940511400502.

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A small Zenker's pouch is a major challenge for endoscopic staple-assisted esophagodiverticulostomy (ESED). This study tested the stapler dimensions so as to identify limitations they impose on ESED. Combining ESED with additional endoscopic suturing could extend the incision and consequently the myotomy. Zenker's diverticulum residual pouch measurements were performed with a previously reported latex glove model and in patients undergoing surgery. Two stapler designs were compared by measuring the residual pouch length for both the stock and modified staplers. One other stapler model cannot be modified without damaging the mechanism. The Endostitch was used to place an additional suture at the apex of the staple line, allowing cutting between the staples while leaving a closed distal incision. All three staplers suitable for ESED leave a residual pouch of 1.5 cm when unmodified. The modified anvil staplers gave a smaller residual pouch by 4 to 5 mm. An additional septal reduction can be accomplished by suturing the area distal to the staple line and incising the party wall beyond the stapler cut. The absolute amount of residual pouch with an additional myotomy is 3 mm. The combined staple-suture technique has proven relatively safe thus far. To provide a maximally efficient myotomy in a patient with a short pouch, the surgeon needs to be aware of the stapler differences. Modifications of the staplers may decrease the depth of the residual pouch, but may carry an added liability. A minimum residual pouch can be achieved with a combination of stapler and suture techniques, but is more technically demanding than the original ESED description.
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Sturiale, Alessandro, Bernardina Fabiani, Claudia Menconi, Danilo Cafaro, Felipe Celedon Porzio, and Gabriele Naldini. "Stapled Surgery for Hemorrhoidal Prolapse: From the Beginning to Modern Times." Reviews on Recent Clinical Trials 16, no. 1 (February 15, 2021): 39–53. http://dx.doi.org/10.2174/1574887115666200310164519e.

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Introduction: Hemorrhoidal disease is the most common proctologic condition in adults. Among the different surgical procedures, one of the greatest innovations is represented by the stapled hemorrhoidopexy. The history of this technique started with a single stapler use passing through a double stapler technique to resect the adequate amount of prolapse, finally coming to the use of high volume devices. Methods: Nevertheless, each device has its own specific feature, the stapler is basically made up with one or more circular lines of titanium staples whose height may be variable. The procedure is based on different steps: Introduction of the CAD, evaluation of the prolapse, fashioning purse string or parachute suture, the introduction of the stapler head beyond the suture, pull the wires through the window, close the stapler and keep pulled the wires of the suture held together with forceps, fire using two hands, open the stapler and remove it and check the staple line and then check the specimen. One of the latest innovations in stapled surgery is Tissue Selective Therapy. It is a minimally invasive procedure in which there is a partial circular stapled hemorrhoidopexy focused on the prolapsing piles with bridges of normal mucosa left. Results: Several studies have reported that SH is a safe and effective procedure to treat hemorrhoidal prolapse. It is a quicker procedure with a shorter hospital stay and earlier return to work if compared with the conventional treatment. This is due to less postoperative pain, postoperative bleeding, wound complications and constipation. Furthermore, the first generation devices had worse outcomes if compared with those of the new generation stapler that showed lower postoperative complication rates with better anatomical and symptomatic results. Conclusions: Stapled procedure for the treatment of symptomatic hemorrhoidal prolapse represents one of the most important innovations in proctology of the last century bringing with it the new revolutionary concept of the rectal intussusception as a determining factor involved in the natural history of the disease. Stapled hemorrhoidopexy marked an era in which the surgeon may offer the patients a safe, effective treatment with less pain and fast recovery.
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Angotti, Lisa M., Christopher Decker, Brittany Pahwa, Carl Rosati, and Todd Beyer. "Internal hernia caused by a free intraperitoneal staple after laparoscopic appendectomy." Case Studies in Surgery 4, no. 1 (May 17, 2018): 14. http://dx.doi.org/10.5430/css.v4n1p14.

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Background: Laparoscopic appendectomy is the gold standard for treatment of appendicitis. Stapled closure of the appendiceal stump is commonly performed and has several advantages. Few prior cases have demonstrated complications from free staples left within the abdomen after the stapler has been fired.Case report: A 29-year-old female underwent laparoscopic appendectomy for acute uncomplicated appendicitis during which the appendix and mesoappendix were divided using laparoscopic gastrointestinal anastomosis (GIA) staplers. Her initial recovery was uncomplicated. She returned on postoperative day 17 with sharp mid-abdominal pain, obstipation, and emesis. Her abdomen was distended, and she had a mild leukocytosis. Computed tomography (CT) demonstrated twisted loops of dilated small bowel in the right lower quadrant with two transition points, suggestive of internal hernia with closed loop bowel obstruction. Diagnostic laparoscopy was performed through the three prior appendectomy incisions. An adhesion between the Veil of Treves and the mesentery of the ileum caused by a solitary free closed staple, remote from the staple lines, had caused an internal hernia. The hernia was reduced, and the small bowel was noted to have early ischemic discoloration. The adhesion was lysed by removing the staple from both structures. The compromised loops of bowel began to show peristaltic movement and color returned to normal, and the procedure was concluded without resection. She was discharged home the following day.Conclusions: Gastrointestinal staplers are commonly used due to ease of use and low complication rate. It is not uncommon to leave free staples in the abdomen as retrieval can be difficult and time consuming. Our case is only the second in the literature reporting an internal hernia with closed loop bowel obstruction as a complication of retained staples. Choosing the most appropriate size staple load to reduce the number of extra staples, removing free staples, or the use of an endoloop can prevent potentially devastating complications.
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Marcet, Jorge, Andrea Ferrara, David E. Rivadeneira, Jose Erbella, and Harry T. Papaconstantinou. "Prospective, Multicenter Randomized Controlled Trial Comparing Two Hemorrhoidopexy Staplers: The HEMOSTASIS Study." International Surgery 103, no. 3-4 (March 1, 2018): 129–38. http://dx.doi.org/10.9738/intsurg-d-15-00171.1.

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The objective of this study was to compare two hemorrhoidopexy staplers (EEA versus PPH03). Stapled hemorrhoidopexy is a treatment option for patients with symptomatic internal hemorrhoids who have failed more conservative measures. However, staple line bleeding remains common. Recent improvements in stapler design have attempted to reduce intraoperative bleeding and the need for intervention. HEMOSTASIS is a prospective, multicenter, 1:1 randomized controlled trial. Twelve hospital centers in the United States enrolled participants between 18 and 85 years of age with symptomatic grades 2 to 3 internal hemorrhoids. The primary end point was intraoperative bleeding, defined as bleeding requiring intervention (e.g., placement of sutures, cauterization, or ligation to achieve hemostasis). Secondary end points included staple line location, postoperative pain, quality of life, operative time, length of hospital stay, adverse events, and complication rates. On the primary end point, the rates of intraoperative bleeding requiring intervention were 41.0% (32 of 78) with EEA and 70.4% (50 of 71) with PPH (P < 0.001). Treatment for active bleeding was required in 30.8% versus 57.7% (P < 0.001) in the EEA and PPH arms, respectively. There were no significant differences between groups in postoperative pain. Adverse events and perioperative complication rates were generally mild/moderate and were similar between groups: 74.1% (60 of 81) of patients in the EEA group reported at least one adverse event versus 80.9% (55 of 68) in the PPH group (P = 0.32). Intraoperative bleeding occurred less often after stapled hemorrhoidopexy with the EEA stapler compared with the PPH03 stapler. Intervention to achieve hemostasis was required less often with the EEA stapler.
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Kathare, Sagar S., and Nandkishor D. Shinde. "A comparative study of skin staples and conventional sutures for abdominal skin wound closures." International Surgery Journal 6, no. 6 (May 28, 2019): 2168. http://dx.doi.org/10.18203/2349-2902.isj20192387.

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Background: The objectives of the study were to study the operative time, the effect on wound healing, cosmetic results, patients acceptance and total cost with the use of sutures and staples.Methods: The study was conducted on 100 patients who were undergoing elective surgery from January 2016 to July 2017 in our institute. The patients were randomly selected to receive either suture or staple.Results: The study group included 50 patients who underwent wound closure by staplers and 50 patients underwent suturing. The commonest region of the surgical wounds was Mc Burneys site. The time taken for wound closure using staplers showed statistically significance difference over closure with suture, it took the stapler 4 times less duration to perform wound closure. The average cost of using stapler was higher than suturing. The appearance of the scar among the staple group was good in 90% of those who returned for follow-up at 1 month, 10% had average scar. The patients acceptance was better in staple group with less pain during removal as compared to suture group. P-value calculated using students unpaired T-test. P<0.0001 which was highly significant.Conclusions: Staples did not cause excess wound pain and allows saving in time with better cosmetic results.
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Basu, S. "Evaluation of Staple Impressions in the Scanning Electron Microscope." Proceedings, annual meeting, Electron Microscopy Society of America 43 (August 1985): 514–15. http://dx.doi.org/10.1017/s0424820100119399.

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Use of the scanning electron microscope (SEM) for examination of tool marks, paricularly firing pin impressions of semi-automatic pistols, selected shotguns and rifles, is well documented. It was the intent of this investigation to apply SEM to staplers, in order to examine if the impressions on the shoe-ends of staples using a particular stapler possessed persisting defects with repeated tackings, and whether these defects can be used as “individual characteristics” in order to be able to identify the source of a staple on tacked papers from a list of eight staplers of different makes and models (Swingline® 747 and 27, ASCO® 40 and ACE® 102). The effects of pre-existing marks, which are usually existent as parallel striations on staples, and the different forms (100% round, 100% round with sharp points and chisel points) of staples on the resulting impression were examined by using different brands of staples (Swingline® standard No. S.F.-1, Swingline® R. W.-35, Bostitch® standard, and ACE® 2025).
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Sato, Masaaki. "Strategies to improve the accuracy of lung stapling in uniportal and multiportal thoracoscopic sublobar lung resections." European Journal of Cardio-Thoracic Surgery 58, Supplement_1 (March 12, 2020): i108—i110. http://dx.doi.org/10.1093/ejcts/ezaa051.

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Abstract The challenges in video-assisted thoracic surgery for sublobar lung resection include difficulty in tumour localization by palpation and difficulty in determining appropriate resection lines. Virtual-assisted lung mapping (VAL-MAP), a bronchoscopic preoperative multispot lung dye-marking technique, allows for both tumour localization and determination of resection lines. To facilitate stapler-based resection, the AMAGAMI or ‘incomplete grasping’ stapler technique is useful to adjust the alignment of the stapler and resection lines. However, when the lung tissue to be stapled is thick, there is unavoidable uncertainty in the staple line inside the lung. We experimentally demonstrated that up to 1 cm of slippage of lung parenchyma occurs at stapling when the stapled lung tissue is &gt;1 cm thick. VAL-MAP 2.0 is a new generation of VAL-MAP combining multispot dye markings with intrabronchial microcoil placement, allowing for 3-dimensional lung mapping and intraoperative navigation using fluoroscopy. The uncertainty of stapling in the lung parenchyma can be partly overcome by VAL-MAP 2.0.
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Agapov, M. A., V. V. Kakotkin, D. R. Markaryan, and T. N. Garmanova. "INTRAOPERATIVE MALFUNCTIONS OF STAPLER DEVICES. THE CURRENT STATE OF THE PROBLEM AND A SERIES OF CLINICAL CASES." Surgical practice, no. 3 (September 22, 2022): 5–11. http://dx.doi.org/10.38181/2223-2427-2022-3-5-11.

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The paper presents several medical device reports from our center identified during application of surgical staplers from different manufacturers. The revealed malfunction did not lead to postoperative complications, however, they affected the duration of the operation and the cost of treatment. Failure of the stapler devices during surgery in the absence of proper attention to the staple line can lead to an increase in the frequency of postoperative complications. It remains unclear the problem of «small» malfunctions of stapler devices, which may go unnoticed during surgery, but affect the outcomes of treatment of patients. In order to identify a possible association between these adverse events and postoperative complications, it is necessary to form a state register of events associated with the use of stapler devices.
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Gupta, Paritosh, Dhruv N. Kundra, Amanpriya Khanna, Akanksha Aggarwal, and Kanu Kapoor. "Our initial experience of three versus two rows circular stapler devices for stapled hemorrhoidopexy: a single institution review of 224 cases." International Surgery Journal 7, no. 3 (February 26, 2020): 685. http://dx.doi.org/10.18203/2349-2902.isj20200505.

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Background: Stapled haemorrhoidopexy is a non-excisional approach for haemorrhoids as opposed to conventional open Milligan-Morgan and Ferguson closed haemorrhoidectomy techniques. It repositions the prolapsed haemorrhoid tissue and also causes vascular interruption to the haemorrhoids. This causes faster recovery and lesser post-operative pain.Methods: In authors institute, stapled haemorrhoidopexy was being carried out using two rows proximate PPH circular haemorrhoidal stapler. In February 2018, MIRUS three rows circular stapler was introduced. This is a retrospective observational study carried out at Artemis Hospital, Gurgaon, India. Authors studied records and operative notes of all patients who underwent stapled haemorrhoidopexy between February 2018 and September 2019 and compared key parameters.Results: A total of 224 patients underwent stapled haemorrhoidopexy between February 2018 and September 2019. 116 using MIRUS three rows circular stapler and 108 using two rows proximate PPH circular haemorrhoidal stapler. Most of the studied parameters were comparable with only significant statistical difference seen in higher use of haemostatic sutures in two rows stapler group compared to three rows stapler group. Haemostatic sutures were needed in three row stapler group for 27 patients and in two rows stapler group for 39 patients.Conclusions: Author’s initial experience shows slightly better haemostasis with three rows stapled haemorrhoidopexy with no significant difference in other parameters.
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Дисертації з теми "Stapler"

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Murakami, Katsuhiro. "Linear or circular stapler? A propensity score-matched, multicenter analysis of intracorporeal esophagojejunostomy following totally laparoscopic total gastrectomy." Kyoto University, 2020. http://hdl.handle.net/2433/253181.

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Staub, Anne-Katrin. "Die Anwendung von Staplern in der abdominalen und thorakalen Chirurgie beim Hund im Vergleich zur bestehenden Literatur." Giessen : VVB Laufersweiler, 2008. http://d-nb.info/989685489/34.

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Bonney, Nora Anne [Verfasser], and Voker [Akademischer Betreuer] Fendrich. "Wertigkeit der Luftprobe nach (Stapler-)Anastomosen bei kolorektalen Anastomosen / Nora Anne Bonney ; Betreuer: Voker Fendrich." Marburg : Philipps-Universität Marburg, 2018. http://d-nb.info/1169312144/34.

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Wilmsen, Johanna Amelie Sophie [Verfasser]. "Flexibel-endoskopische Stapler-Zenker-Divertikulotomie : eine multizentrische Fallserie mit einem neuen endoskopischen Behandlungsverfahren / Johanna Amelie-Sophie Wilmsen." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2018. http://d-nb.info/1153769182/34.

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Wilmsen, Johanna Amelie-Sophie [Verfasser]. "Flexibel-endoskopische Stapler-Zenker-Divertikulotomie : eine multizentrische Fallserie mit einem neuen endoskopischen Behandlungsverfahren / Johanna Amelie-Sophie Wilmsen." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2018. http://d-nb.info/1153769182/34.

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Akil, Ali [Verfasser], and Stefan [Akademischer Betreuer] Fischer. "Elektrisch betriebenes Stapler-System (iDrive) versus mechanischer Klammernahthandgriff in der minimal-invasiven Lungenchirurgie : Ergebnisse einer prospektiv randomisierten Studie / Ali Akil ; Akademischer Betreuer: Stefan Fischer ; Klinikum Ibbenbüren." Hannover : Bibliothek der Medizinischen Hochschule Hannover, 2019. http://d-nb.info/1201831601/34.

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Wallimann, Herbert [Verfasser], Claus-Dieter [Akademischer Betreuer] Heidecke, Claus-Dieter [Gutachter] Heidecke, and Godehard [Gutachter] Friedel. "Vergleichende Studie der vaskulären Berstungsdrücke nach Stapler-Transsektion mit B- und D-Form-Klammernahtgeräten in einem neuartigen Testverfahren / Herbert Wallimann ; Gutachter: Claus-Dieter Heidecke, Godehard Friedel ; Betreuer: Claus-Dieter Heidecke." Greifswald : Ernst-Moritz-Arndt-Universität, 2018. http://d-nb.info/1157011535/34.

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Bornscheid, Jens. "Stapled Stock = (Verbundaktien) /." Frankfurt am Main [u.a.] : Lang, 2006. http://www.gbv.de/dms/spk/sbb/recht/toc/502180196.pdf.

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Armstrong, Jim. "Short Staple Variety Comparison." College of Agriculture, University of Arizona (Tucson, AZ), 1985. http://hdl.handle.net/10150/203925.

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Layton, Dennis, Ron Cluff, Claude Evans, Sam Stedman, Bruce Church, and Billy Moore. "Short Staple Variety Demonstrations." College of Agriculture, University of Arizona (Tucson, AZ), 1985. http://hdl.handle.net/10150/204046.

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Книги з теми "Stapler"

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Staples, Garth E. The Staples family of Staples Brook. [Charlottetown, P.E.I.]: G.E. Staples, 1986.

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Morgan, Alison. Staples for Amos. London: Walker, 1986.

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Bornscheid, Jens. Stapled Stock: (Verbundaktien). Frankfurt am Main: P. Lang, 2006.

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1932-, Measham Donald, and Windsor Bob, eds. Staple: New writing. Mickleover: School of Humanities, Derbyshire CHE, 1989.

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1932-, Measham Donald, and Windsor Bob, eds. Staple: New writing. Mickleover: School of Humanities, Derbyshire CHE, 1991.

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Homemade snacks and staples. New York, New York: Alpha, a member of Penguin Group (USA) Inc., 2013.

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Kang, Manjit S., and P. M. Priyadarshan, eds. Breeding Major Food Staples. Oxford, UK: Blackwell Publishing Ltd, 2007. http://dx.doi.org/10.1002/9780470376447.

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Kasper, Juneann. Stapled duplexing job analysis. Little Falls, NJ: Minnella Enterprises, 1994.

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S, Kang Manjit, and Priyadarshan P. M, eds. Breeding major food staples. Ames, Iowa: Blackwell, 2007.

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Malolo, Meleʾofa. The staples we eat. Noumea, New Caledonia: South Pacific Commission, 1999.

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Частини книг з теми "Stapler"

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Bruns, Helge, Jürgen Weitz, Michael Kremer, Markus W. Büchler, and Peter Schemmer. "Stapler Hepatectomy." In Open, Laparoscopic and Robotic Hepatic Transection, 69–74. Milano: Springer Milan, 2012. http://dx.doi.org/10.1007/978-88-470-2622-3_10.

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Pescatori, Mario. "Stapler circolare nelle fistole." In Ascessi, fistole anali e retto-vaginali, 105. Milano: Springer Milan, 2011. http://dx.doi.org/10.1007/978-88-470-1914-0_37.

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Ulrich, B., and N. Kockel. "Collare Stapler-Anastomose nach Ösophagusresektion." In Verhandlungen der Deutschen Gesellschaft für Chirurgie, 647–48. Berlin, Heidelberg: Springer Berlin Heidelberg, 1988. http://dx.doi.org/10.1007/978-3-642-48161-1_261.

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Wittgrove, Alan, and Tomasz Rogula. "Circular Stapler Technique for Gastroenterostomy." In Minimally Invasive Bariatric Surgery, 237–46. New York, NY: Springer New York, 2007. http://dx.doi.org/10.1007/978-0-387-68062-0_27.

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Veiga, João, Carlos Ventura, and João Pedro Mendonça. "Stapler Anvil Groove Profile Optimization." In Lecture Notes in Mechanical Engineering, 395–409. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-79165-0_37.

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Feingold, Daniel L., and Ravi P. Kiran. "Cannot Extract the Circular Stapler." In Colorectal Surgery Consultation, 133–34. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-11181-6_32.

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Kästei, M. "Lungenmetastasenresektion — Klemmenresektion / Lung-Metastasectomy: Stapler Resection." In Deutsche Gesellschaft für Chirurgie, 924. Berlin, Heidelberg: Springer Berlin Heidelberg, 2001. http://dx.doi.org/10.1007/978-3-642-56458-1_392.

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Nyström, Per-Olof, and Rune Sjödahl. "Circular Stapler Anopexy For Prolapsing Haemorrhoids." In Surgical Treatment of Haemorrhoids, 97–104. London: Springer London, 2002. http://dx.doi.org/10.1007/978-1-4471-3727-6_14.

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Hölscher, A. H., and J. R. Siewert. "Stapler am Gastrointestinaltrakt — pro und contra." In Klammernahttechnik in der Chirurgie, 37–55. Berlin, Heidelberg: Springer Berlin Heidelberg, 1993. http://dx.doi.org/10.1007/978-3-642-78113-1_3.

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Böttcher, K., A. Stier, J. D. Roder, M. Etter, and J. R. Siewert. "Ergebnisse der Ösophagojejunoplikatio in Stapler-Technik." In Pouch, 325–31. Berlin, Heidelberg: Springer Berlin Heidelberg, 1998. http://dx.doi.org/10.1007/978-3-642-72132-8_39.

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Тези доповідей конференцій з теми "Stapler"

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Kalapay, Dan, and Charles Kim. "Design of a Compliant Energy Storage Impulse Mechanism for a Desktop Stapler." In ASME 2008 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. ASMEDC, 2008. http://dx.doi.org/10.1115/detc2008-49451.

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Анотація:
This paper outlines the research, design and testing of a compliant staple gun style mechanism for use in a desktop model stapler. A survey of existing staple gun style desktop staplers is used to create target specifications to design the new compliant stapler. The initial proof of concept satisfies the primary function and user specifications. Future iterations of the mechanism will be tested and designed to be capable of performing the repeated iteration of long term stapler use.
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Riggs, Marie K., Matt R. Bohm, and Philip J. Mountain. "Examining Relationships Between Device Complexity and Failure Modes of Minimally Invasive Surgical Staplers." In ASME 2016 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2016. http://dx.doi.org/10.1115/imece2016-66750.

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Анотація:
Minimally invasive surgery (MIS) has become the standard approach for an increasing number and variety of procedures. Designing devices for such surgeries presents many challenges and must address efficiency, accuracy, and ease of use. The complexity of a device’s design likely influences its performance in real life situations. Therefore, identifying the complexity and potential for failures of a device is crucial in the early stage of design in order to ensure the effectiveness and safety of the final product. A complexity measure is explored utilizing design variables such as the maximum number of connections, number of total elements, and number of unique elements within a device. Reverse engineering of medical devices has been completed to begin understanding such complexity variables. The overall objective of this research is to determine the correlation between a medical device’s complexity measure and its failure modes. The nature and frequency of problems associated with various surgical medical devices must be characterized. This paper is an initial investigation and focuses on surgical stapling devices for MIS. The analysis pertains strictly to surgical staplers that simultaneously staple and transect tissue with a design that allows insertion through small incisions via a trocar, wound protector and retractor, or direct insertion. Adverse event reports involving minimally invasive surgical staplers have been retrieved from the U.S. Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database from January 2006 – January 2016 and examined to determine trends in the characterization of device problems and prevalence of such problems. A total of 13,312 reports are included in the analysis. 106 events resulted in death, 3234 resulted in injury, and 9972 involved a device malfunction. A yearly analysis has been conducted analyzing the trends in event type (death, injury, and malfunction) and device brands involved in the reports over the past decade. A sample of reports was taken in order to perform a detailed analysis of the event descriptions. The reports are categorized by phase and description of failure modes associated with surgical stapler use. The phases of use in which failures occur have been identified as packaging, reload, articulation, application, firing, cutting, removal, and staple line. FDA recall information associated with these devices was also investigated. An extensive study regarding adverse events reported to the FDA associated with surgical staplers has not been completed since 2004 to the authors’ knowledge, nor a study investigating this specific category of surgical stapling devices. These devices are constantly evolving in regards to their design features, and their application is expanding to more wideranging open and MIS procedures. Despite the prevalence of minimally invasive surgical stapler use, any incident of failure may put a patient’s health and safety at risk. Malformed staples as a result of the firing phase, removal issues, and leaking staple lines were the main contributors to surgical stapler failure in the adverse event reports analyzed. Bariatric and thoracic surgery accounted for the majority of procedure types identified within the reports. The range of procedures in the analysis verifies the expansion of surgical stapler use and application. Various failure modes can be attributed to user error; however, the FDA recall information associated with these devices indicates that device failure shares responsibility. The results of this work contribute to the awareness of both surgical stapling device designers and users, and the importance of such must be heavily emphasized in order to prevent future complications in the field.
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Jansen-Winkeln, B., JP Takoh, SM Rabe, C. Chalopin, I. Gockel, and H. Köhler. "Handnaht v. Stapler-Anastomose – Hyperspektralbetrachtung der Perfusion." In Viszeralmedizin 2019. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1695191.

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Khanzode, Dhruva, Ranjan Jha, Damien Chablat, and Emilie Duchalais. "Stapler Design With Stacked Tensegrity Mechanisms for Surgical Procedures." In ASME 2022 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2022. http://dx.doi.org/10.1115/detc2022-89714.

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Abstract In this paper, a planar mechanism formed by stacking tensegrity mechanisms has been designed. This mechanism is formed by three segments but the approach can be applied to a larger number of segments. This mechanism is studied to serve as a stapler for laparoscopic rectal cancer surgery where conventional tools cannot be easily accessed. To do this, two identical mechanisms will be used and operated similarly: one to carry the clips and the cutting knife and the second in parallel to allow the closing of the clips by bringing the two mechanisms together. The parameterization of the segments allows a variation of all lengths. Thus, the size of the segments can decrease proportionally from the base to the top, resulting in a tapered shape from the base to the tip like an elephant trunk. The mechanism has linear springs and cables for its actuation. The singularities, as well as the stability of the parallel mechanism, were analyzed using the minimum energy principle. Optimization was also performed to obtain the largest angular deflection for a segment based on a ratio between the size of the base and the moving platform of the robotic system. The result of this work is a family of mechanisms that can generate the same workspace for different stability properties. After optimization, the radius of curvature of the mechanism will be studied to allow insertion into the patient’s belly.
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Liao-yuan, Ai, Ge Shu-chen, Xu Jing-jing, Li Ming-yang, Mao Lin, and Song Cheng-li. "Finite Element Analysis and Experiment on Large Intestine End-to-End Anastomosis." In 2018 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2018. http://dx.doi.org/10.1115/dmd2018-6832.

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Colorectal surgery is widely performed to re-establish the bowel, the part of which is removed because of diverticulitis, intestinal polyps, inflammatory bowel and cancer. Stapled anastomosis is a highly standardized technique and considered the standard of care. However, complications like leakage, stenosis and postoperative bleeding cannot be completely avoided [1,2]. There is limited understanding of the impact of staplers on tissue and basic mechanics of tissue stapling. According to the previous research, compression, staple height, tissue thickness, tissue compressibility, and tissue type have an effect on the patient outcomes [3]. Hence, we conducted this prospective study to analyze the effect of staple height on tissue damage and compression pressure. An attempt was made to determine the relationship between the tissue height and the optimal closed staple height.
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Sugimoto, T., K. Ozawa, and Y. Higashiyama. "An electrostatic sheet stapler using positive and negative corona charging." In 2015 IEEE Industry Applications Society Annual Meeting. IEEE, 2015. http://dx.doi.org/10.1109/ias.2015.7356754.

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Breinlich, V., and O. Reichel. "Closing of a small Zenker Diverticulum without myotomy using a stapler-device." In Abstract- und Posterband – 91. Jahresversammlung der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn – Welche Qualität macht den Unterschied. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1710798.

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McAdams, Daniel A., and Kristin L. Wood. "Theoretical Foundations for Tuning Parameter Tolerance Design." In ASME 2000 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2000. http://dx.doi.org/10.1115/detc2000/dfm-14003.

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Abstract In this paper a novel technique is presented to solve tolerance design problems. To achieve the desired performance tolerance, the technique uses a subtle, but significant, change in the design rather than increasing component precision. This change is the addition of a tuning parameter. Statistical models are used to developed a framework for the tuning parameter design method. Also developed is a new dimensionless design parameter which ranks candidate tuning parameters. The step-by-step tuning parameter design method is applied to a heavy duty manual stapler as a clarifying example.
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Schineis, C., T. Fenzl, C. Kamphues, ME Kreis, and JC Lauscher. "Stapler vs. Handnaht bei intestinalen Anastomosen – gibt es Unterschiede bei Effizienz, Komplikationen und gesundheitsökonomischen Faktoren?" In Viszeralmedizin 2019. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1695190.

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Hashim, D., F. Meyer, and N. Albayrak. "Laparoscopische extraperitoneale endoscopische stapler-baseierte sublay operation (LEESS) mit transversus abdominis release wie ich es mache." In Viszeralmedizin 2021 Gemeinsame Jahrestagung Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Sektion Endoskopie der DGVS, Deutsche Gesellschaft für Allgemein und Viszeralchirurgie (DGAV). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1734108.

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Звіти організацій з теми "Stapler"

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Seybold, Patricia. Staples. Boston, MA: Patricia Seybold Group, June 2006. http://dx.doi.org/10.1571/cs6-8-06cc.

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Research Institute (IFPRI), International Food Policy. Land productivity for staple food crops. Washington, DC: International Food Policy Research Institute, 2014. http://dx.doi.org/10.2499/9780896298460_14.

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Droller, Federico, and Martin Fiszbein. Staple Products, Linkages, and Development: Evidence from Argentina. Cambridge, MA: National Bureau of Economic Research, June 2019. http://dx.doi.org/10.3386/w25992.

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Marshak, Ronni. How Well Does Staples Help a Small Company "Manage My Stuff?". Boston, MA: Patricia Seybold Group, July 2011. http://dx.doi.org/10.1571/cea07-21-11cc.

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Bohorquez-Penuela, Camilo, and Mariana Urbina-Ramirez. Rising Staple Prices and Food Insecurity: The Case of the Mexican Tortilla. Banco de la República de Colombia, November 2020. http://dx.doi.org/10.32468/be.1144.

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We study the relationship between rising prices of tortillas---the Mexican staple par excellence---and household food insecurity between 2008 and 2014, a period in which global food prices experienced dramatic increases. The use of a unique combination of household-level data and official state-level information on prices allows us exploit signi cant variation in prices across the Mexican states. Since households cannot be tracked across time, we follow Deaton (1985) by constructing a series of pseudo-panels to control for time- invariant unobserved heterogeneity and measurement error. The regression estimates suggest that increasing tortilla prices affected food insecurity rates in Mexico. More speci cally, households with children or those in the second or third income quintile are more likely to be affected.
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Silvis, Huib, Raymond Schrijver, and Allard Jellema. Stapelen van beloningen voor natuurinclusieve landbouw : een lonkend perspectief? Wageningen: Wageningen Economic Research, 2022. http://dx.doi.org/10.18174/573120.

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Mehta, Parvez, Mitchell Driggers, and Carole Winterhalter. Development of Flame Resistant Combat Uniform Fabrics Made from Long Staple Wool and Aramid Blend Yarn. Fort Belvoir, VA: Defense Technical Information Center, April 2013. http://dx.doi.org/10.21236/ada578994.

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Smith, Joshua E. Orion Staples of C-IIAC Wins the 2017 American Chemical Society Division of Inorganic Chemistry Undergraduate Research Award. Office of Scientific and Technical Information (OSTI), May 2018. http://dx.doi.org/10.2172/1438100.

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Papadopoulos, Ioannis. STAPL-RTS: A runtime system for massive parallelism. Office of Scientific and Technical Information (OSTI), May 2016. http://dx.doi.org/10.2172/1492943.

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Mairo, Amy, and Mardik Leopold. Stapels bruinvissen! Hoe verhoudt een snelle massa-sectie zich tot het lopende dieet-onderzoek? Den Helder: Wageningen Marine Research, 2018. http://dx.doi.org/10.18174/448545.

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