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

Colorectal surgery

Maximize blood flow,1,†
maximize confidence

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Colorectal surgery:
The main challenges

In colorectal surgery, every procedure is unique and can be challenging in its own way. Anatomical variations, restricted access or obstruction, extensive bleeding, inadvertent trauma, inflammation or infection, and anastomotic leaks – can all impact performance and patient recovery.

To confidently navigate these challenges, colorectal surgeons can rely on Tri-Staple™ technology and energy devices.

Confidently navigate
colorectal challenges

Maximizing blood supply to the anastamotic site is crucial in reducing the risk of anastomotic leaks. The intricate handling and twisting of the bowel during resection can inadvertently compromise blood flow which can undermine performance and lead to an unsatisfactory procedural outcome. 

Tri-Staple™ technology’s graduated compression profile and varied height staples allow greater perfusion into the staple line.1,†

Products that enhance outcomes
Signia™ Stapling System

The world's first smart stapler10

The Signia™ Stapling system works with a variety of existing Medtronic Stapling reloads and the portfolio of compatible reloads is continually expanding. When coupled with Tr-Staple 2.0 reloads it provides real-time feedback to help empower surgical decision making.11,††

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GIA™ stapler with Tri-Staple™ technology

Ensuring the right amount of pressure, the GIA™ stapler with Tri-Staple™ technology:

  • May allow greater perfusion into the staple line as compared to two-row linear staplers6,7,§,§§
  • Provides stronger staple line leak pressure as compared to two-row linear staplers8,9,ΩΩ
  • Generates less stress on tissue during compression and clamping as compared to two-row linear staplers6,7,§,§§

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Black Reload with Tri-Staple™ Technology

An advanced stapler reload solution for thick tissue applications. Specifically designed for use in extra-thick tissue.

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EEA™ circular stapler with
Tri-Staple™ technology

For improved blood supply, the EEA™ circular stapler with Tri-Staple™ technology:

  • Facilitates improved healing with 140% greater perfusion into the staple line2,3,‡,§
  • Offers 80% fewer leaks4,§,Ω
  • Delivers less stress on tissue compared to the Ethicon™* CDH stapler’s flat-faced cartridges during compression and clamping5,††,‡‡

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Anastomotic leak-rate reduction

Check out the clinical summaries

Three‑row versus two‑row circular staplers for left‑sided colorectal anastomosis: a propensity score‑matched analysis of the iCral 2 and 3 prospective cohorts.

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Preliminary evaluation of two‑row versus three‑row circular staplers for colorectal anastomosis after rectal resection: a single‑center retrospective analysis.

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Effectiveness of a new triple-row circular stapler in reducing the risk of colorectal anastomotic leakage: A historical control and propensity score–matched study.

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Clinical impact of the triple-layered circular stapler for reducing the anastomotic leakage in rectal cancer surgery: Porcine model and multicenter retrospective cohort analysis.

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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™ Maryland jaw device

Trust in confidence

Ligasure Maryland’s curved jaws securely and atraumatically grasp tissue12,13,††† to allow for easy skeletonization of vessels.12,14,†††

  • A multifunctional device with one–step sealer15
  • The LigaSure™ Maryland device provides improved access compared to straight jaws12,14,†††

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Sonicision™ 7 curved jaw cordless ultrasonic device

Trust in freedom

Sonicision™ 7 curved jaw provides improved access and gives surgeons the freedom to navigate tight spaces deep in the pelvis.

  • The tapered jaw design of the Sonicision™ 7 curved jaw device allows for precise access to tissue planes16,†††
  • The jaw curvature of the Sonicision™ 7 curved jaw device allows for proper access to critical structures16,‡‡‡
  • The jaws of the Sonicision™ 7 curved jaw device allow surgeons to hug (or follow) curved anatomical structures16,§§§

See solutions

† Compared to flat-faced cartridges with single-height staples.
‡ Based on staple-line vascularity analysis using MicroCT in an in vivo canine model (CDH31P: n = 13; TRIEEA31XT: n = 15. P = 0.007). 
§ Preclinical results may not correlate with clinical performance in humans.
Ω Based on leak testing in an in vivo canine model. Comparing TRIEEA25XT to Ethicon™* CDH25P (n = 9; P = 0.023), where 50 mm Hg represented a maximum expected colonic pressure.
†† Bench test results may not necessarily be indicative of clinical performance.
‡‡ Finite element analysis (FEA) was used to determine the strain profiles of three circular staplers during clamp-up. The EEA™ circular stapler with Tri-Staple™ technology demonstrated a graduated compression profile upon clamping.
§§ Based on perfusion analysis of Endo GIA™ staplers with Tri-Staple™ technology’s graduated-height staple lines vs. Ethicon Echelon™* two-row, single-height staple lines (EGIA n =12, Ethicon n = 14; p = .011).
ΩΩ Compared to GIA™ staplers with  DST Series™ technology.
††† 30 of 33 surgeons surveyed after use agreed.
‡‡‡ 33 of 33 surgeons surveyed after use agreed.
§§§ 31 out of 32 surgeons surveyed after use agreed.

  1. Based on internal test report #2128-002-2, Final analysis of staple-line vascularity using MicroCT. July 2015.
  2. Based on internal report #RE00330708 rev 1, Perfusion analysis for circular staplers, comparing EEA™ circular stapler with Tri-Staple™ technology. May 13, 2021.
  3. Smallwood N, Mutch MG, Fleshman JW. The failed anastomosis. In: Complexities in Colorectal Surgery: Decision-Making and Management. New York, NY: Springer Science and Business Media; 2014:277–304.
  4. Based on internal report #RE00365456, Comparative in vivo leak testing for EEA™ circular staplers with Tri-Staple™ technology (TRIEEA25XT) and Ethicon Echelon Circular™* Powered stapler (CDH25P). Dec. 21, 2021.
  5. Based on internal test report #RE00200393 rev.2 Comparison of circular staplers: tissue compression profiles as determine by 2-D static axisymmetric finite element analysis (FEA). June. 17, 2021.
  6. Based on report # RE00222215, Endo GIA™ Tri-Staple™ testing performed and design similarities between Lily and Endo GIA™ Tri-Staple™ technology memo. Oct. 16, 2019.
  7. Eschbach M, Sindberg GM, Godek ML, et al. Micro-CT imaging as a method for comparing perfusion in graduated-height and single-height surgical staple lines. Med Devices (Auckl). 2018;11:267–273.
  8. Based on report# RE00171002 rev 0, 80 mm GIA™ Stapler with Tri-Staple™ technology purple and black design verification report. Aug. 14, 2019.
  9. Based on internal test report #RE00324614 Rev A2 Comparative Testing versus Competitive Devices. May 2021 (v1.0)
  10. Based on internal report RE00026887
  11. Based on internal RE00055515_SAGES. 2016
  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 #R0035742, Maryland validation, 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 #RE00071598, Maryland validation labs, Houston and Los Angeles: independent surgeon feedback collected during porcine labs. April 16–18 and April 30–May 3, 2013.
  15. Ligasure™ Maryland Jaw Sealer/Divider, Nano-Coated [instructions for use]. Boulder, CO: Medtronic ; 2016.
  16. 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.