Abstract
We performed aortic arch replacement with a circular staple gun (Intraluminal Stapler System, ILS; Ethicon Endo-Surgery Inc, Somerville ,N J), an automatic anastomosis device used in gastrointestinal surgery. The features of the ILS are adjustable stapler height and controlled compressed tissue thickness, allowing uniform staple formation and providing a leak-free anastomosis and good hemostasis. The circular staple gun has been used in gastrointestinal operations since the 1980s, but its early use was controversial. Now that the device has been standardized, this first report of clinical use in aortic aneurysm surgery is pivotal and likely to change practice in cardiovascular surgery. CLINICAL SUMMARY
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