Asymmetrical cutting and stapling, a new concept in the use of staplers

About the changes proposed by Dr. Santoro to improvethe safety of stapling, I agree that they could promotehemostasis and sealing of stapling in procedures such assleeve gastrectomy.As discussed in my article published in Obesity Surgery[1], my model of "asymmetrical stapler", proposes a cutlateral to apply more rows of staples in the gastric remnantand less in the resected stomach. Thus, not only could createmodels 4×2 rows of staples, but also of 5×1 or even 3×1models could be created; smaller intruments but equally safethan current. This is therefore a “functional design”, whichcan be applied to all fields of resective surgery and wouldbe perfectly compatible with the other improvements suchas the system of different sizes of staples, biomaterialsand so on. I am pleased to see that Dr. Santoro has alreadythought of this new concept before [2] and match the opinionof other experts consulted by me. I hope that the medicalindustry can incorporate this change in the coming years.