ECHELON FLEX™ GST System
Control tissue slippage during firing
4x less tissue slippage† for the most precise transection
Uniquely designed for better grip‡ to provide the least tissue slippage§ for the most precise transection. Proprietary Gripping Surface Technology provides superior tissue grip‡ without additional trauma during firing.¶ This means you can transect more of the tissue§ you intended - especially in very thick tissue - with each firing.
7x more likely to fully capture mucosa**
Better mucosal capture†† for improved leak resistance€
Better mucosal capture improves staple line integrity and leak resistance€, and promotes optimal conditions for tissue healing.†† By controlling tissue movement, the ECHELON FLEX™ GST System more consistently captures both layers of mucosa in the staple line.
Exceptional staple line integrity
Reliability across the broadest range of tissue thicknesses‡‡
Surgeon-controlled stapling delivers closed staple height formation reliability through a proprietary combination of multi-stage compression, powered firing and Gripping Surface Technology, including stronger internal reload components and redesigned staple geometry to mitigate the amount and effect of tissue slippage during firing.
Performance for robotic procedures
In thick tissue testing, 0 occurrence of compromised staple line integrity§
The ECHELON FLEX™ GST System delivers superior staple line integrity for robotic procedures compared to EndoWrist® Stapler. In thick tissue, EndoWrist® Stapler 45 required multiple clamp attempts,¶¶ produced 3x more malformed staples\\ and had a significantly higher occurrence of compromised staple line integrity.§§
* System components include ECHELON FLEX™ Powered Plus Stapler and ECHELON ENDOPATH™ Reloads with Gripping Surface Technology
† Benchtop testing in porcine stomach tissue. Mean tissue movement from after clamping on tissue to after firing ECHELON FLEX™ Powered Plus Stapler (PSEE60A) and ECHELON Reloads with GST vs ENDO GIA™ ULTRA Handle (EGIAUSTND) and Endo GIA™ Reloads with Tri-Staple™ Technology at 3.3 and 4.0mm tissue thicknesses (3.3mm: GST60T 0.642mm vs EGIA60AMT 4.806mm p<0.001; 4.0mm: GST60T 0.654mm vs EGIA60AXT 5.116mm p<0.001).
‡ Benchtop testing in porcine stomach tissue. Mean peak load required to pull tissue from the clamped jaws of ECHELON FLEX™ Powered Plus Stapler (PSEE60A) and ECHELON Reload with GST vs ENDO GIA™ ULTRA Handle (EGIAUSTND) and Endo GIA™ Reload with Tri-Staple™ Technology (GST60B 6.496lbf & GST60T 7.789lbf vs EGIA60AMT 1.325lbf & EGIA60AXT 1.920lbf, all p<0.001).
§ Benchtop testing in porcine stomach tissue. Mean tissue movement from after clamping on tissue to after firing ECHELON FLEX™ Powered Plus Stapler (PSEE60A) and ECHELON Reloads with GST vs ENDO GIA™ ULTRA Handle (EGIAUSTND) and Endo GIA™ Reloads with Tri-Staple™ Technology at 1.5, 2.5, 3.3 and 4.0mm tissue thicknesses (1.5mm: GST60B 1.067mm vs EGIA60AMT 2.452mm p<0.001; 2.5mm: GST60G 1.148mm vs EGIA60AMT 3.261mm p<0.001; 3.3mm: GST60T 0.642mm vs EGIA60AMT 4.806mm p<0.001; 4.0mm: GST60T 0.654mm vs EGIA60AXT 5.116mm p<0.001).
¶ Based on acute and long term evaluations in animate porcine stomach, bowel, lung and vasculature. Visual comparisons of 10-20 second clamp and release and full firing staple lines immediately following, 1hr after clamping, 14 days post op and at necropsy, as well as histological evaluation at 14 days post op, revealed no additional clinically relevant trauma to the tissues.
** ECHELON FLEX™ GST System Blue and Green Reloads compared to Endo GIA™ with Tri-Staple™ Technology Purple Reloads evaluated via gross observations of firings in 1.5mm to 3.0mm thick animate porcine ileum. Mucosal capture was rated via a 5-point Likert scale with the best rating representing fully captured mucosa. Mucosal capture was evaluated in a preclinical study comparing compression damage, mucosal injury and mucosal capture on varying thicknesses of porcine gastrointestinal tissue utilizing a 5-point Likert scale. The ECHELON FLEX™ GST System had a higher percentage of firings that were rated as having good mucosal apposition (12.1% GST vs 1.7% Tri-Staple™) and a lower percentage of firings that were rated as having poor mucosal apposition (10% GST vs 24% Tri-Staple™).
†† GST System Blue and Green Reloads compared to Endo GIA with Tri Staple™ Technology Purple Reloads evaluated via gross observations of firings in 1.5mm to 3.0mm thick animate porcine ileum. Mucosal capture was rated via a 5 point Likert scale with the highest rating representing fully captured mucosal. Average apposition ratings 2.81 (GST60B) and 2.56 (GST60G) vs 3.23 (EGIA60AMT), p=0.001.
€ Benchtop testing of GST System 60mm Green and Blue and Tri-Staple 60mm Purple reloads in porcine ileum. Location of initial staple line leak was associated with site of incomplete mucosal capture in 46 of 59 firings that resulted in incomplete mucosal capture. Additional testing demonstrated no significant performance difference between 60mm and 45mm reloads of the same brands.
‡‡ Comparison of the ECHELON FLEX™ GST System designed to accommodate a compressed tissue thickness range of 1.0mm to 4.0mm vs the Medtronic Tri-Staple portfolio intended for a thickness range of 0.75mm to 3.0mm (Medtronic literature, downloaded from Medtronic website on Nov 16, 2016).
§§ Benchtop testing on excised porcine stomach (3.3mm tissue thickness) of GST (PCEE60A, Green-GST60G) vs. EndoWrist™ (410298, Green-41445G) that defined compromised staple line integrity/failures as groups of malformed staples that could potentially allow fluid to pass to the cut line (p=0.006).
¶¶ Benchtop testing on excised porcine stomach of EndoWrist™ (410298, Green41445G) that measured the number of “inadequate clamp” messages encountered for each firing by the da Vinci Si system at 3.3mm tissue thickness (n=14/15 had ≥ 3 attempts)
\\ Benchtop testing on excised porcine stomach of GST (PCEE60A, Green-GST60G) vs. EndoWrist™ (410298, Green-41445G) that measured overall non-B staple form quality at 3.3mm tissue thickness (p<0.001)