TY - JOUR A1 - Novacek, V. A1 - Tran, Thanh Ngoc A1 - Klinge, U. A1 - Tolba, R. H. A1 - Staat, Manfred A1 - Bronson, D. G. A1 - Miesse, A. M. A1 - Whiffen, J. A1 - Turquier, F. T1 - Finite element modelling of stapled colorectal end-to-end anastomosis : Advantages of variable height stapler design T2 - Journal of Biomechanics N2 - The impact of surgical staplers on tissues has been studied mostly in an empirical manner. In this paper, finite element method was used to clarify the mechanics of tissue stapling and associated phenomena. Various stapling modalities and several designs of circular staplers were investigated to evaluate the impact of the device on tissues and mechanical performance of the end-to-end colorectal anastomosis. Numerical simulations demonstrated that a single row of staples is not adequate to resist leakage due to non-linear buckling and opening of the tissue layers between two adjacent staples. Compared to the single staple row configuration, significant increase in stress experienced by the tissue at the inner staple rows was observed in two and three rows designs. On the other hand, adding second and/or third staple row had no effect on strain in the tissue inside the staples. Variable height design with higher staples in outer rows significantly reduced the stresses and strains in outer rows when compared to the same configuration with flat cartridge. KW - Variable height stapler design KW - Anastomotic leakage KW - Finite element modelling KW - End-to-end colorectal anastomosis KW - Surgical staplers Y1 - 2012 UR - https://opus.bibliothek.fh-aachen.de/opus4/frontdoor/index/index/docId/4811 SN - 1873-2380 VL - 45 IS - 115 SP - 2693 EP - 2697 PB - Elsevier CY - Amsterdam ER -