Medtronic I-Drive vs Ethicon Echelon: A Head-to-head Randomized Controlled Trial
Chelsey McKinnon, Ryan Yang, Cara Reitz, Aaron Lane, Daniel Roubik, John P Schriver, Eric P Ahnfeldt
Bariatric surgery, Linear stapler, Minimally invasive surgery
Citation Information :
McKinnon C, Yang R, Reitz C, Lane A, Roubik D, Schriver JP, Ahnfeldt EP. Medtronic I-Drive vs Ethicon Echelon: A Head-to-head Randomized Controlled Trial. World J Lap Surg 2022; 15 (1):65-68.
The views expressed in this publication/presentation are those of the author(s) and do not reflect the official policy or position of William Beaumont Army Medical Center, Department of the Army, Defense Health Agency, or the US Government.Background: There have been numerous studies comparing various aspects of bariatric surgery, such as hand sewn vs stapled anastomoses, electronic vs manual staplers, and reinforced vs nonreinforced staple lines. There has never been a randomized controlled trial comparing different staplers in sleeve gastrectomies.
Methods: Our study was a randomized control trial comparing the staple reload time, complications, and stapler cost for the Medtronic I-Drive and the Ethicon Echelon. Our primary endpoints were time, hemostasis, bleeding, necessity for transfusion, and leak rate in a military system.
Results: Sixty-three patients were consented for the study with a final number of 26 in the Echelon arm and 25 in the I-Drive arm after fallout. There were a total of 140 stapler reloads in the Echelon arm and 123 in the I-Drive arm. The median staple reload times were 39.78 seconds for the I-Drive and 41.77 seconds for the Echelon (p = 0.42). The total time for sleeve creation was 12.14 minutes in the Echelon arm and 14.26 minutes in the I-Drive arm (p = 0.04). There were two misfires in each group (four total) and no positive leak tests, transfusions, or postoperative complications. The average cost for staplers, reloads, and reinforcement for the I-Drive was $2,037.26 for the civilian rate and $2,097.66 for the government rate. The average cost for the Echelon was $1,835.65 for the civilian rate and $2,268.97 for the government rate.
Conclusion: The Medtronic I-Drive and the Ethicon Echelon are comparable in reload time, stapler misfires, leak test rates, and cost.
WBAMC IRB Study Trial Number: NCT02731079.
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