The validity of the AEON™ stapler in gastrointestinal surgery: early clinical experience and translational rationale

Background/need: Gastrointestinal stapling continues to be limited by bleeding, variable compression and leak-related morbidity, especially in bariatric and hepatopancreatobiliary (HPB) surgery. The AEON™ stapler was developed to improve uniformity of compression and staple formation. Methodology and device description: AEON™ uses an S3 (sustained, smooth and stable) compression mechanism to reduce tissue shear and optimise B-shaped staple formation. Evidence comes from a randomised controlled trial in sleeve gastrectomy, a large bariatric cohort and observational HPB series. Preliminary results: Across 1, 848 bariatric cases, only one staple-line leak occurred, and 428 consecutive AEON™ cases had no stapler-related complications. A sleeve gastrectomy trial showed significantly reduced intraoperative bleeding. In a 250-patient comparison, reinforcement was required in 16.8% of AEON™ cases versus 100% using a tri-staple device. Distal pancreatectomy with AEON™ showed a pancreatic fistula rate of 20% compared with 65% for traditional staplers, and major hepatectomy was completed without transfusion in any AEON™ case. Current status: AEON™ is in active clinical use with early results supporting improved haemostasis and postoperative outcomes. Larger prospective studies are underway.