TST36 - Grapadora para terapia de selección de tejidos

Grapadora interna de un solo uso

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TST36 - Tissue-selecting Therapy Stapler
  • La eficacia de la resección con grapas (hemorroidal o rectal) se ha comunicado sistemáticamente a lo largo del tiempo1-13. Sin embargo, la tasa de recidiva y algunas complicaciones relacionadas con este procedimiento, tales como la hemorragia o el fracaso de la anastomosis, siguen generando algunas controversias14.
  • La resección se realiza "a ciegas" y con limitaciones en la cantidad de pared rectal que se puede resecar, lo que puede explicar algunas de las dificultades y complicaciones experimentadas con las técnicas de resección transanal con grapadora15.
  • Aunque los dispositivos introducidos recientemente, como la contour Transtar, permiten una resección mayor, los pacientes con un prolapso rectal importante pueden necesitar una sutura adicional de la anastomosis rectal con un mayor riesgo de fallo de la línea de grapas16.
  • Algunas de estas complicaciones importantes podrían minimizarse utilizando un dispositivo quirúrgico que permita el control completo y continuo del procedimiento bajo visión directa.

[1] Renzi A, Brillantino A, Di sarno G, D’Aniello f, Giordano A, stefanuto A, et al. PPH-01 versus PPH-03 to perform sTARR for the treatment of hemorrhoids associated with large internal rectal prolapse: a prospective multicenter randomized trial. surg Innov. 2011;18:241-7.

[2] Boccasanta P, Venturi M, Roviaro G. What is the benefit of a new stapler device in the surgical treatment of obstructed defecation? Three-year outcomes from a randomized controlled trial. Dis colon Rectum. 2011;54:77-84.

[3] Ommer A, Rolfs TM, Wals MK. Long-term results of stapled transanal rectal resection (sTARR) for obstructive defecation syndrome. Int J colorectal Dis. 2010;25:1287-92.

[4] Jayne DG, schwandner O, stuto A. stapled transanal rectal resection for obstructed defecation syndrome: one-year results of the european sTARR Registry. Dis colon Rectum. 2009;52:120

[5] Lenisa L, schwandner O, stuto A, Jayne D, Pigot f, Tuech JJ, et al. sTARR with contour Transtar: prospective multicentre european study. colorectal Dis. 2009;11:821-7.

[6] Arroyo A, González-Argenté fX, García-Domingo M, espin-Basany e, De-la-Portilla f, Pérez-Vicente f. Prospective multicentre clinical trial of stapled transanal rectal resection for obstructive defaecation syndrome. Br J surg. 2008;95:1521-7.

[7] Boccasanta P, Venturi M, stuto A, Bottini c, c aviglia A, carriero A, et al. stapled transanal rectal resection for outlet obstruction: a prospective, multicenter trial. Dis colon Rectum. 2004;47:1285-96.

[8] Boccasanta P, Venturi M, salamina G, cesana BM, Bernasconi f, Roviaro G. new trends in the surgical treatment of outlet obstruction: clinical and functional results of two novel transanal stapled techniques from a randomised controlled trial. Int J colorectal Dis. 2004;19:359-69.

[9] Gravié Jf, Lehur PA, Huten n, Papillon M, fantoli M, Descottes B, et al. stapled hemorrhoidopexy versus milligan-morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann surg. 2005;242:29-35.

[10] s enagore AJ, singer M, Abcarian H, fleshman J, corman M, Wexner s, et al. Procedure for Prolapse and Hemmorrhoids (PPH) Multicenter study Group. A prospective, randomized, controlled multicenter trial comparing stapled hemorrhoidopexy and ferguson hemorrhoidectomy: perioperative and one-year results. Dis colon Rectum. 2004;47(11):1824-36.

[11] c orrea-Rovelo JM, Tellez O, Obregón L, Miranda-Gomez A, Moran s. stapled rectal mucosectomy vs. closed hemorrhoidectomy: a randomized, clinical trial. Dis colon Rectum. 2002;367-1374.

[12] Boccasanta P, capretti PG, Venturi M, cioffi U, De simone M, salamina G, et al. Randomised controlled trial between stapled circumferential mucosectomy and conventional circular hemorrhoidectomy in advanced hemorrhoids with external mucosal prolapse. Am J surg. 2001;182:64-8.

[13] Ho YH, cheong WK, Tsang c, Ho J, eu KW, Tang cL, et al. stapled hemor-rhoidectomy-cost and effectiveness. Randomized, controlled trial including incontinence scoring, anorectal manometry, and endoanal ultrasound assessments at up to three months. Dis colon Rectum. 2000;43:1666-75.

[14] naldini G. serious unconventional complications of surgery with stapler for haemorrhoidal prolapse and obstructed defaecation because of rectocoele and rectal intussusception. colorectal Dis. 2011;13:323-7.

[15] naldini G, Martellucci J, Rea R, Lucchini s, Di Visconte M, caviglia A, Menconi c, et al. Tailored prolapse surgery for the treatment of haemor-rhoids and obstructed defecation syndrome with a new dedicated device: TsT sTARR Plus. Int J colorectal Dis. 2014;29(5):623-9.

[16] Petersen s, s chinkel B, Jürgens s, Taylessani c, s chwenk W. Impact of prolapse mass on contour Transtar technique for third-degree rectal prolapse. Int J colorectal Dis. 2013;28(7):1027-30