Comparative Analysis of Hemostasis and Staple-Line Integrity between Medtronic Tri-Staple with Preloaded Buttress Material and the AEON Stapler in Bariatric Surgery

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Bariatric

Comparative Analysis of Hemostasis and Staple-Line Integrity between Medtronic Tri-Staple with Preloaded Buttress Material and the AEON Stapler in Bariatric Surgery

Gabrielle Hogan, BSc; Ravi Rao, MBBS, FRACS, FASMBS; Aditya Rao, BSc; Faran Talebi, MBBS
Private hospital, Australia

Journal of the Society of Laparoscopic and Robotic Surgeons (JSLS), June 2024

250
Total patients
125 vs. 125
AEON vs. Tri-Staple cohorts
Zero
Complications in either group
Key finding: AEON demonstrated non-inferiority to Medtronic Tri-Staple with preloaded buttress material. Zero intraoperative or 30-day complications, deaths, ER visits, readmissions, or reoperations in either group. AEON group had significantly shorter hospital stay. AEON group had significantly longer mean operative time. Single-surgeon design.

Abstract

Background and Objectives:
Haemostasis-related complications associated with Medtronic Tri-stapleTM with preloaded buttress material and the novel, naked AEONTM gastrointestinal staplers have not been extensively studied in bariatric surgery. The study aimed to assess and compare the 30-day haemostasis-related complications between Medtronic Tri-stapleTM and AEONTM GIA staplers.

Methods:
A retrospective analysis was performed on data from patients who underwent primary or revision sleeve gastrectomy (SG) or the sleeve component of single anastomosis duodeno-ileal bypass with SG (SADI-S) in a private hospital in Australia between November 2021 and December 2022. The surgeries were performed by a single surgeon, using either Medtronic Tri-stapleTM or AEONTM staplers.

Results:
The analysis included 250 patients, with the first 125 consecutive patients receiving staple line using the Medtronic Tri-stapleTM GIA stapler and the subsequent 125 patients receiving staple line using the AEONTM GIA stapler. Statistical analysis revealed no significant differences in the distribution of surgical procedures between the Medtronic and AEON groups. In the AEON group, there were statistically higher numbers of diabetics and former tobacco users, while other preoperative characteristics did not significantly differ between the two groups. The AEON group had a significantly longer mean operative time, while the length of hospital stay was significantly shorter. No intraoperative or 30-day complications, deaths, emergency room visits, readmissions, or reoperations were observed in either group.

Conclusion:
The novel, naked AEONTM stapler demonstrated non-inferiority to the established Medtronic Tri-stapleTM with preloaded buttress material in achieving hemostasis and maintaining staple-line integrity in bariatric surgery.

*Abstract text reproduced from the original publication with attribution to the authors and publisher. All rights remain with the respective copyright holders. Reproduced here for informational and educational purposes in accordance with applicable open-access licensing or fair use principles. For the definitive version, refer to the original publication via the link provided.

Clinical Relevance: For bariatric surgeons currently using buttress-reinforced staple lines, this data demonstrates that AEON achieves non-inferior hemostasis without the added cost and complexity of buttress material. The zero complication rate in both groups across 250 patients is notable. The single-surgeon design controls for technique variability, strengthening the comparison. Surgeons should note the longer operative time in the AEON group, which the authors attribute to the learning curve with a new device.
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