a hand - held surgical stapler is provided having a reduced distal profile due to a unique feeding means . a combination of features allows the reduced distal profile . the staple storage cover can be of reduced distal thickness due to the slope effect . the staple pusher has the capability at its distal end to push and by pushing lift all of the staples , including the last , into the staple track . provisions are made on the staple pusher to allow the form tool to displace it out of the staple track to allow forming of the last staple . nose assemblies are disclosed which can be interchangeably mounted to various trigger assemblies . the pre - load on the stored staples can be varied . a ratchet feature requires full depression of the trigger before it can be returned to a neutral or extended position and full extension of the trigger to its neutral position prior to initiation of the next staple feed cycle .