Thoracic surgery

Reduce air leaks,
increase confidence

Thoracic surgery:
The main challenges

Prolonged air leaks (PALs) from an unstable staple line occur in up to one in four lung resections¹ — increasing the risk of postoperative complications, longer hospital stays, and increased morbidity. The risk of vascular injury is higher in more complex surgeries and can result in significant blood loss, prolonged surgery, and the need to repair the injury.

Thoracic surgeons can be confident that our portfolio of Tri-Staple™ technology and surgical energy devices, will deliver key clinical benefits for them and their patients.

The confidence to navigate
complex procedures with ease

In the challenging high-pressure environment of the OR, thoracic surgeons need to be confident that they can handle any challenge. Tri-Staple™ technology reloads have a stepped cartridge face that delivers graduated compression and three rows of varied height staples. This provides superior strength and leak resistance^2,3,†,‡ while generating less stress on tissue during compression and clamping.^4,5,§,Ω

Products that enhance outcomes

Signia™ small diameter reload

For greater access to intricate vascular structures, Signia™ small diameter reload provides:

10 times less tension on vessels during clamping^6,†,§§
30% greater access than the Ethicon Flex™* powered vascular stapler^7,ΩΩ
49% reduction in distal tip motion during firing, which may produce less trauma to surrounding tissues^{8,†,†††}
Superior hemostasis^{9, ‡‡‡, §§§}

Unlike other endoscopic reloads with Tri-Staple™ technology, Signia™ small diameter reloads deliver 2, double staggered rows of staples.

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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 clamping^{10, §§§}
Greater perfusion^{10, §§§}
Superior performance across a broad range of thicknesses^{10, §§§}

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Reinforced reloads with Tri-Staple™ technology

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

A significant reduction in the likelihood of air leaks in pulmonary lobectomies^11,††
50% fewer postoperative air leaks compared to nonbuttressed reloads in pulmonary lobectomies^11,††
41% fewer patients required a chest tube^12,‡‡

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Signia™ Stapling System

The world's first smart stapler¹³

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.^14,*

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It takes confidence
to build trust

Check out the resources

Learn more

Read the product information

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 thoracic jaw device

Trust in confidence

Delicate thoracic tissue requires a strong seal to prevent vascular injury. LigaSure™ Maryland thoracic jaw is a multifunctional device with the benefits of a Maryland dissector, grasper, and cold scissors combined with the safety of LigaSure™ technology.^15,16

Significantly higher burst pressure on large pulmonary vessels sealed with the LigaSure™ Maryland jaw thoracic device LF1930T (297 mmHg) is 13% higher than the average for Harmonic Ace™ +7 (258 mmHg)^{17,†,ΩΩΩ,††††,‡‡‡‡}
The first minimally invasive advanced energy device specifically indicated for sealing pulmonary veins and arteries/vessels up to, and including, 7mm^18,ΩΩΩΩ

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†Bench test results may not necessarily be indicative of clinical performance.
‡Staple line strength: Endo GIA™ tan reload vs. Echelon Flex™* white reload and Endo GIA™ purple reload vs. Echelon™* green, gold, and blue reloads. Leak resistance: In-vitro synthetic leak comparison: Endo GIA™ purple reload vs. Echelon™* blue and gold.
§Compared to 􀆿at-faced cartridges with single-height staples.
ΩCompared to Echelon Flex™* green reloads analysis comparing different stapler designs, performance and impact on tissues under compression using 2-D 􀆾nite element analysis.
††Compared to nonbuttressed reloads. P = 0.006.
‡‡Compared to Echelon Flex™* nonbuttressed reloads during pulmonary resections.
§§Compared to the Echelon Flex™* powered vascular stapler 35 mm white 2.5 mm cartridge reloads. SDR: n = 10; PVS: n = 18. P =0.000.
ΩΩCompared to the Ethicon Echelon Flex™* powered vascular stapler.
†††Compared to 12 mm reloads with Tri- Staple™ technology.
‡‡‡Based on testing in porcine and canine models, compared to Ethicon Echelon Flex™* powered vascular stapler. SDR: n = 98; PVS: n = 87. P = 0.020.
§§§Preclinical results may not correlate with clinical performance.
ΩΩΩHarmonic™* devices are indicated for thoracic use, however LigaSure™ Maryland jaw thoracic device LF1930T is speci􀆾cally indicated for pulmonary arteries and veins.
††††The LF1930T is only compatible with the Valleylab™ FT10 energy platform
‡‡‡‡Based on bench top testing using animal tissue.
ΩΩΩΩAs of March 23, 2018, based on indications for use for laparoscopic LigaSure™ devices
* 15 out of 16 surgeons surveyed after use agreed when compared to larger 12 mm reloads

Hoeijmakers F, Hartemink KJ, Verhagen AF, et al. Variation in incidence, prevention and treatment of persistent air leak after lung cancer surgery. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2021;61(1):110-117. doi:10.1093/ejcts/ezab376
Based on internal test report #PCG-001, Tyvek pull-apart test comparing Echelon™* and Tri-Staple™ technology. March 2011.
Based on internal test report #PCG-002, In-vitro leak comparison. March 08,2011.
Based on internal test report #PCG-007 rev 1, Perfusion into Clamped Media. Sept. 2, 2011.
Based on internal test report #PCG-018, 2-D FEA of linear staplers. November 2012.
Based on internal report #RE00209946, Vessel tension analysis: Signia™ small diameter reload vs. Echelon™ PVS. Sept. 17, 2019.
Based on report #RE00142825, Image creation for Signia™ small diameter reload. March 26, 2019.
Based on internal report #RE00220106, Distal tip motion evaluation: Signia™ small diameter reload vs. Tri-Staple™ 2.0 technology. Sept. 17, 2019.
Based on internal report #RE00190239, Signia™ small diameter reload chronic study statistical analysis. March 26, 2019.
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
Deguchi H, Tomoyasu M, Shigeeda W, Kaneko Y, Kanno H, Saito H. Reduction of air leakage using linear staple device with bioabsorbable polyglycolic acid felt for pulmonary lobectomy. Gen Thorac Cardiovasc Surg. 2020;68(3):266–272.
Shigeeda W, Deguchi H, Tomoyasu M, et al. The utility of the stapler with PGA sheet for pulmonary wedge resection: a propensity score-matched analysis. J Thorac Dis. 2019; 11: 1546–1553.
Based on internal report RE00026887
Based on internal RE00055515_SAGES. 2016
Based on internal test report #RE00140529 rev A, LigaSure™ Maryland device, nano-coated (LF19XX) tissue testing (memo). Mar. 5, 2018.
LigaSure™ Maryland jaw Sealer/Divider Nano-coated [instructions for use]. Boulder, CO: Medtronic; 2016.
Based on internal report #RE00158693, Comparison of Vein Seal Burst Pressure with the Harmonic™* HD1000i, Harmonic Ace™* +7 and LigaSure™ Thoracic Maryland Jaw device (LF1930T). October 8-9, 2018.
Based on internal report #RE00147462, Pulmonary sealing claims for the LigaSure™ Maryland jaw thoracic device LF1930T device (memo). March 29, 2018.

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Reduce air leaks, increase confidence

The confidence to navigate complex procedures with ease