IBC Oxford University Oral Abstract 38 - Endrive ZERO: pushing forward efficiency and safety in stapling technology

Abstract Introduction Endrive ZERO: Pushing Forward Efficiency and Safety in Stapling Technology Intro: Since their first appearance in 1908 by the Hungarian surgeon Hümér Hültl, Surgical Staplers (SS) have gained massive popularity due to their surprising results, improving surgical safety, complication rates and operative time optimization. Along evolution, SS have been modified according to needs and surgical approaches. From open surgeries to laparoscopy. From manual firing to electric devices. From two rows of staples in each side, to 3-row ones, always divided by the final blade section. To parallel lines, to alternate ones. From linear curling tissue compression to 3D improving innovation. However, there was no such evolution in the staple’s rows disposition. It has always been a simetric stapling, equal amount in each side of the section, even in resective techniques, such as Oncological Surgeries, and among Bariatric Surgery, Sleeve Gastrectomy (SG) particularly. In fact, in these techniques, half of the staples are lost due to specimen extraction, while the exact quantity stays in the remaining tissue, wasting 50% of them. Objective: To assess and to demonstrate the non-inferiority of the new surgical stapling device Endrive ZERO, which provides a 4-row stapling in the remaining tissue, and a 2-row stapling in the resected one. Methods From February 2024 to June 2024, 56 patients undergoing SG were recruited with a minimum follow-up of 30 days. 46 were women. There were 6 surgeons participating in this study. Revisional Surgery cases were excluded. All of the procedures were performed with the new Endrive ZERO 60 mm, which provides a 4-row stapling in the remaining tissue, and a 2-row stapling in the resected one. All stapler loads were fired through a 15 mm supra-umbilical trocar, closed posteriorly with EndoClose system. Variables evaluated were Operative Time (OT) (in minutes), 30-day Complication Rate, Hospital Stay (in hours), Total Bleeding Loss (in ml), Analgesia Requirement (in Opiod-Equivalent Consumption) and Pain Management (Visual- Analogical Scale). Results Mean initial BMI was 38.7. Mean OT was 41.7 min. Hospital Stay was 24.5. The average of hemostatic clips needed was 1.3. No postoperative complications were reported within 30 days. No hemostatic reinforcement or buttressing material was needed. Average Opioid Consumption (morphine equivalent) was 3.75 mg. No incisional hernia cases were reported in any case. No re-admission nor mortality was registered. Conclusion The new Endrive ZERO stapler is safe and effective. Despite the low volume of patients recruited, this stapler seems promising in term of complication and mortality rates enhancement. Further studies with longer follow-up and higher volume are needed to confirm this preliminary report.