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

Background and objectives: Haemostasis-related complications associated with Medtronic Tri-staple^TM with preloaded buttress material and the novel, naked AEON^TM 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-staple^TM and AEON^TM 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-staple^TM or AEON^TM staplers.

Results: The analysis included 250 patients, with the first 125 consecutive patients receiving staple line using the Medtronic Tri-staple^TM GIA stapler and the subsequent 125 patients receiving staple line using the AEON^TM 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 AEON^TM stapler demonstrated non-inferiority to the established Medtronic Tri-Staple^TM with preloaded buttress material in achieving hemostasis and maintaining staple-line integrity in bariatric surgery.