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Medtronic / Covidien Products / Surgical Stapling / Surgical stapling innovation / Tri-Staple™ technology / Bariatric Surgery

Bariatric surgery

Tackle variable tissue
with confidence

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Bariatric surgery:
The main challenges

In bariatric surgery, particularly in procedures that involve creating a stapled gastric pouch or sleeve, staple line leaks are a known complication. If the staple fails to hold the tissue together, it can result in a potentially life-threatening leak. Patients who experience a staple line leak may require extended hospitalization, additional surgeries, and prolonged recovery times.

Surgeons can be confident in the reliability of their staple lines with support from Tri-Staple™ technology and surgical energy devices from Medtronic.

Minimize complications to
increase confidence

In bariatric surgery, a strong staple line is crucial to minimizing complications. With unique design features, reloads with Tri-Staple™ technology deliver superior performance across a broad range of thicknesses.1-5,†,‡

The universal system alongside our extensive reload portfolio gives you ultimate flexibility in your procedure8,‡‡ so that you can adapt to any challenge with the correct solution.

Products that enhance outcomes

Reinforced reloads with Tri-Staple™ technology

Preload confidence and strengthen staple lines. Reinforced reloads with Tri-Staple™ technology provide:

  • Significantly higher burst pressure compared to nonbuttressed reloads6,§
  • 15 times lower incidence of bleeding compared to nonbuttressed reloads7,Ω
  • More efficiency, saving an average of 7 to 10 minutes8,††

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Reloads with Tri-Staple™ technology

Tri-Staple™ technology reloads are designed to work in harmony with the natural properties of tissue before, during, and after stapling.

  • Less stress on tissue during compression and clamping9,†
  • Greater perfusion9,†
  • Superior performance across a broad range of thicknesses9,†

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Reload tissue thickness indication compared to tissue variability in obese patients
Check the resources: 

Tissue Thickness of Human Stomach Measured on Excised Gastric Specimens from Obese Patients

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Tri-Staple 2.0 Specialty Reloads Experience Paper

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Effectiveness of bedside staplers in bariatric robotic procedures

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It takes confidence
to build trust

Our Surgical Energy portfolio is built on 50 years of trusted innovation. Our offerings deliver confidence, performance, and freedom in the OR to advance healthcare worldwide.
LigaSure™ retractable L-hook

Trust in confidence

Improve surgical efficiency by reducing the need for instrument exchanges with LigaSure™ retractable L-hook.10,‡‡ Enhance surgical flow with one step activation and the functionality of five laparoscopic devices together in one versatile instrument.

  • Monopolar precision across three modes11
  • Deliver improved access to targeted tissues compared to straight jaw devices — even in tight spaces,12,13,§§

See LigaSure™ solutions
Sonicision™ 7 curved jaw cordless ultrasonic device

Trust in freedom

Increase procedural efficiency and improve outcomes by spending less time in the OR.14,15,ΩΩ

  • The activation time of the Sonicision™ 7 curved jaw device is 21% faster than the activation time for the Ethicon Ace+7 through different tissue types16,‡‡‡
  • The dissection speed of the Sonicision™ 7 curved jaw device is 24% faster than the Harmonic HD1000i device when performing multiple activations in (max) dissection mode17,§§§

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†Preclinical results may not correlate with clinical performance in humans.
‡Bench test results may not necessarily be indicative of clinical performance. Compared to Ethicon Echelon Flex™*
§Study performed on the crotch of a side-to-side anastomosis in an ex-vivo porcine model.
ΩBased on an analysis of the addition of reinforcement to the staple line in high risk laparoscopic sleeve gastrectomy vs. no reinforcement.P = 0.005.
††Compared to an aftermarket buttress. Results based on n of 125 OR nurses and 125 surgeons.
‡‡27 out of 29 surgeons evaluated agreed.
§§31 of 33 surgeons surveyed after use agreed.
ΩΩ29 out of 33 surgeons surveyed after use agreed.
†††24 out of 29 (82%) nurses surveyed after use answered extremely easy (59%) or easy (24%).
‡‡‡Testing performed on in-vivo model. Tissue types included isolated vasculature and A/V bundles, root of the small bowel mesentery, small bowel mesentery, broad ligament, omentum (p=0.0002)
§§§Testing performed on bench model and measured across 10 consecutive activations (p=0.0002)

  1. Based on internal test report #PCG-001, Tyvek pull-apart test comparing Echelon™* and Tri-Staple™ technology. March 2011.
  2. Based on internal test report #PCG-004, Undercrimp comparisons in increasing pads of foam between Echelon™* and Tri-Staple™ technology. January 2012.
  3. Based on internal test report #PCG-006, Staple formation comparison between Medtronic EGIA60AXT and Ethicon ECR60G in an ex-vivo tissue model. January 2012.
  4. Based on internal test report #PCG-018, 2-D FEA of linear staplers. November 2012.
  5. Based on internal test report #PCG-019, Comparative test of Endo GIA™ stapler using black reloads with Tri-Staple™ technology and Ethicon Echelon Flex™* black reloads. June 2014.
  6. Kimura M, Shibata Y, Mori Y. Novel attempt using bioabsorbable reinforcement material on the crotch of a side-to-side anastomosis. Indian J Surg. 2018;80(6):559–563.
  7. Gayrel X, Loureiro M, Skalli EM, Dutot C, Mercier G, Nocca D. Clinical and economic evaluation of absorbable staple line buttressing in sleeve gastrectomy in high-risk patients. Obes Surg. 2016;26(8):1710-1716.
  8. Based on internally-sponsored study conducted by ORC International, Survey of tissue reinforcement users to determine waste and time loss attributed to separately loaded buttressmaterials in the OR. Online U.S. national sample of 125 surgeons and 125 OR nurses. Nov. 9, 2011.
  9. Based on internal test report #RE00498029 Competitive Evidence Final Report Signia with Tri-Staple Technology vs Intuitive's Da Vinci Robotic Stapling System with SureForm SmartFire Technology Competitive Evidence Final
  10. Based on internal test report #RE00032739 Rev A, LigaSure™ Hook (LF5637, LF5644) validation surgeon evaluation report: independent surgeon feedback collected during Medtronic sponsored cadaver and porcine lab conducted in Houston, Texas. February 2016.
  11. Based on Medtronic Internal: Craig, J. Valleylab Mode™: A Comparison With Conventional Electrosurgery. Boulder: N.p. Print.
  12. Based on internal test report #RE00140529 rev A, LigaSure™ Maryland device, nano-coated (LF19XX) tissue testing (memo). Mar. 5, 2018.
  13. Based on internal test report #RE00071598, Maryland validation labs, Houston and Los Angeles: independent surgeon feedback collected during porcine labs. April 16–18 and April 30, May 3, 2013.
  14. Based on internal test report #R0042752 rev A, Marketing evaluation of surgeon experience using the Sonicision™ curved jaw cordless ultrasonic dissector. Feb. 13–17, Feb. 28, March 3, May 16, 2017.
  15. Based on internal test report #R0049393 rev A, Operating room staff marketing evaluation of the Sonicision™ curved jaw cordless ultrasonic dissector. Dec. 1, 6–7, 2016.
  16. Based on internal test report #RE00341899 rev A, Market Research Pre-Clinical Report - Acute Porcine Study Comparison with the SPD-85, Thunderbeat Type S, Harmonic Ace+7, Harmonic HD1000i, SPD-83, and LigaSure LF18XX and LF19XX Devices; July 26,27, 30 2021.
  17. Based on internal test report #RE00341903 rev A, Market Research Report – Thermal Pro􀆾le Comparison with the SPD-85, Thunderbeat Type S, Harmonic Ace+7, Harmonic HD1000i, SPD-83, and LigaSure LF18XX and LF19XX Devices; August 3rd, 4th, 5th, and September 15th, 2021.