Surgical Procedure and Stapler Technique
angulation
PNEUMOPERITONEUM, STOMACH
Each patient was administered 40 mg of enoxaparin subcutaneously 12 h before
surgery. Pneumoperitoneum was created after routine placement of four ports.
A Nathanson liver retractor was routinely used. Stomach dissection was
performed using an energy device (LigaSure Atlas; Covidien LLC, United States).In the waiting group, after the staple was locked into the stomach,
compression was applied for 30 s, and firing was performed in four
continuous motions (15 mm per movement). After firing was completed, the
punch jaws were left compressed for another 30 s without opening, after
which the jaws were opened and the process was completed. The first stapler
was fired at 0°, the second at 9°, and a routine angulation of 18° was given
to the third and subsequent staplers. In the non-waiting group, firing and
cutting were performed without waiting after tissue locking with the
stapler, without changing the order of use.