Ethicon Endo-Surgery Intraluminal Stapler (ILS)

Ethicon Endo-Surgery
Intraluminal Stapler (ILS)
Steps to Use
Steps to Use
Step 1: Turn the twist handle of the
instrument anticlockwise until the
colour marking is visible.
Step 2: Remove the staple guard
and place this on the instrument
table.
Step 3: Pull the detachable head
from the central rod and also place
this on the instrument table.
Step 4: Retract the trocar by rotating the adjusting knob clockwise …
… until a stop is reached and the
trocar is fully retracted.
Step 5: With the aid of a pursestring suture clamp apply a pursestring suture on the organ to be
anastomosed.
Step 6: Insert the detachable anvil
into the lumen.
Step 7: Secure the purse string
onto the anvil shaft above the tying
notch. Ensure that the locking
springs can still move freely.
Step 8: Introduce the instrument
transanally with the trocar retracted
and slide it forward carefully up to
the staple line.
Step 9: Fully extend the trocar and
pierce the tissue by gently rotating
the adjusting knob counterclockwise.
The bowel wall should be pierced
next to the staple line.
Step 10: Expose the trocar completely until the orange tying area
is visible.
Step 11: Take hold of the shaft of the
detachable head with a grasper.
Please ensure that the locking springs
can still move freely
Step 12: Reattach the detachable
head assembly by sliding the anvil
shaft over the trocar, and pushing
until the detachable head is fully
engaged and a snap can be heard.
Step 13: Close the instrument by
turning the knob in a clockwise direction. Ensure that the bowel ends are
correctly oriented and that no
foreign tissue is present in the area
of the anastomosis.
Step 14: Close the instrument until
orange indicator is in green range of
the tissue compression scale. Adjust
the closed staple height according to
tissue thickness; wait 15 sec. to allow
for adequate tissue compression; confirm that tissue resistance is still felt, if
not, turn the knob clockwise until tissue
resistance is felt.
Step 15: Draw back the red safety
toward the adjusting knob. If the
safety cannot be released, the instrument is not in the firing range.
Step 16: To fire, squeeze the firing
handle with a firm, steady pressure.
Step 17: The surgeon will feel
reduced trigger pressure and hear
a “crunch” as the instrument completes the firing cycle.
Step 18: After firing, release the
firing handle allowing it to return to
its original position and re-engage
safety lever.
Step 19: Open the instrument
turning the adjusting knob counterclockwise using a ½ to ¾ rotation.
Step 20: To withdraw the open
instrument, gently apply rearward
traction while simultaneously rotating
Step 21: Open up the instrument
completely to inspect the doughnuts.
Remove anvil and washer from within
the circular stapler.
Step 22: Slide the donuts onto the
shaft of the detached anvil.
Step 23: Examine the integrity of the
donuts. Donuts should be intact and
include all tissue layers. If donuts are
not complete, the anastomosis should
be carefully checked for leakage and
appropriate repairs made.
For complete product details always refer to latest instructions of use.
Nomenclature
Dual-stage closing mechanism
closes rapidly at first, but slows as
tissue is approximated to ensure
control of compression
Non-reflective sealed shaft (ECS)
designed to prevent loss of
pneumoperitoneum during
laparoscopic approach
Non-slip grip and reduced grip span
provides increased comfort and control.
Patented cutting washer
provides audible and tactile
feedback indicating the firing
sequence is complete
New: Larger Tissue Compression Scale
2.5mm
Designed for visibility and ease of use
Markings in the
green range
correspond to
the following
compressed
tissue thicknesses:
2,5 mm
2,0 mm
1,5 mm
1,0 mm
Firing in the green
range delivers a
closed staple height
appropriate for
compressed tissue
thickness (between
1.0mm and 2.5mm).
1.0mm
Ethicon Endo-Surgery (Europe) GmbH
Hummelsbütteler Steindamm 71
22851 Norderstedt, Germany
BR 525.1
©2011 Ethicon Endo-Surgery.
For complete product details always refer to latest instructions of use.