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Purpose <p>Stapled closure is the standard technique for pancreatic resection via distal pancreatectomy (DP). The Signia™ Stapling System allows for adaptive stapling based on real-time tissue resistance. This study aims to investigate whether DP using the Signia™ system could reduce the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF).</p> Methods <p>We retrospectively analyzed 53 patients who underwent DP between 2020 and 2025. 26 patients underwent DP using the Signia™ Stapling System (powered stapler group), and 27 patients using a manual stapler (manual stapler group). The primary outcome was the CR-POPF rate.</p> Results <p>In the powered stapler group, 38.5% of patients developed biochemical leakage, but no cases of CR-POPF were observed. In contrast, the manual stapler group had a CR-POPF rate of 18.5% (<i>p</i> = 0.021). A receiver operating characteristic curve was generated to determine the pancreatic thickness threshold predictive of CR-POPF. The calculated cut-off value was 16&#xa0;mm. In the powered group, there were no cases of CR-POPF even if the pancreatic thickness at the resection line was ≥ 16&#xa0;mm.</p> Conclusions <p>The use of a powered stapler may therefore help reduce the risk of POPF associated with variability in the thickness and hardness of the pancreas during DP.</p>

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Use of a reinforced triple-row stapler with a powered stapling system reduces the occurrence of postoperative pancreatic fistula after distal pancreatectomy

  • 期刊论文

  • 发表日期：

    2025年8月27日

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  • Shinjiro Kobayashi,
  • Keisuke Ida,
  • Saori Umezawa,
  • Kazunari Nakahara,
  • Keisuke Tateishi,
  • Tomoko Norose,
  • Nobuyuki Ohike,
  • Tsuyoshi Morimoto,
  • Shinya Mikami,
  • Takehito Otsubo

摘要

Purpose

Stapled closure is the standard technique for pancreatic resection via distal pancreatectomy (DP). The Signia™ Stapling System allows for adaptive stapling based on real-time tissue resistance. This study aims to investigate whether DP using the Signia™ system could reduce the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF).

Methods

We retrospectively analyzed 53 patients who underwent DP between 2020 and 2025. 26 patients underwent DP using the Signia™ Stapling System (powered stapler group), and 27 patients using a manual stapler (manual stapler group). The primary outcome was the CR-POPF rate.

Results

In the powered stapler group, 38.5% of patients developed biochemical leakage, but no cases of CR-POPF were observed. In contrast, the manual stapler group had a CR-POPF rate of 18.5% (p = 0.021). A receiver operating characteristic curve was generated to determine the pancreatic thickness threshold predictive of CR-POPF. The calculated cut-off value was 16 mm. In the powered group, there were no cases of CR-POPF even if the pancreatic thickness at the resection line was ≥ 16 mm.

Conclusions

The use of a powered stapler may therefore help reduce the risk of POPF associated with variability in the thickness and hardness of the pancreas during DP.