Rating and issues of mechanical anastomotic staplers in surgical practice: a survey of 241 Japanese gastroenterological surgeons.

Purpose: Commercially available mechanical devices for gastrointestinal anastomosis are mostly made in overseas. Japanese female surgeons have described these devices as being too large and difficult to handle. This study investigated the degree of satisfaction and problems experienced by Japanese surgeons in using various staplers for mechanical anastomosis.

Methods: A questionnaire was prepared and sent via email to 5,537 members of the Japanese Society of Gastroenterological Surgery. The questionnaire included sex, age, surgical glove size, degree of satisfaction with various mechanical staplers, stress felt when using the staplers in anastomosis, and problems regarding the devices.

Results: Valid responses were received from 241 respondents (167 males, 74 females, response rate 4.9 %). The satisfaction rate ranged from 0 to 100 %. The average glove size in males was significantly larger than that in females (median: 7.0 versus 6.0; P < 0.0001). Surgeons with glove size 6.0 or smaller felt stress more frequently than those with size 6.5 or larger (median: 40 vs. 20 %; P < 0.0001). Surgeons with glove size 6.0 and smaller experienced more difficulties during firing and releasing.

Conclusion: The satisfaction rates with currently available mechanical staplers were low. Japanese surgeons with small hands felt more stress when using the staplers. Ergonometric consideration is necessary in stapler design.