By collaborating with leaders in the surgical community, the design of the ECHELON FLEX ENDOPATH Stapler is grounded in Halsted's principles of surgery – the importance of hemostasis and the gentle handling of tissue.

The first and only articulating mechanical endocutter with true one-handed operation, the ECHELON FLEX ENDOPATH Stapler is designed to deliver optimal system-wide compression by combining a precision-machined anvil with 3-point gap control. You get uniform, consistent staple formation for hemostasis in a wide range of tissue thicknesses.

It is:

• Designed to respect tissue – through enhanced system-wide compression and uniform, consistent staple formation
• Easy to use – true one-handed operation and facilitates tissue positioning/manipulation with its wide proximal-to-distal jaw aperture
• Unique – natural articulation allows the surgeon to focus on the line of transection and place the anvil exactly where needed
• Comfortable – shorter grip span than previous Ethicon Endo-Surgery Endocutters for greater comfort and ease of use
• Cost-efficient – procedures call for fewer codes and cartridges; and with value articulation built into the instrument, you pay for articulation once per case

ECHELON FLEX ENDOPATH Staplers are sterile, single-patient-use articulating instruments that simultaneously cut and staple tissue. They deliver six staggered rows of staples, three on either side of the cut line.  They are offered with staple cartridge lengths of 60mm and 45mm, and come in long or compact shaft lengths. It is the first articulating mechanical stapler/cutter that can be operated with only one hand.

With its natural articulation, the shaft can rotate freely in both directions. An articulation mechanism enables the distal portion of the shaft to pivot to facilitate lateral access to the operative site.

Features include:

• Superior endoscopic staple lines in thick tissue.*
• Enhanced system-wide compression before and during firing for uniform, consistent staple formation.
  • Pre-compression for smoother stapling service for uniform hemostatic staple line.
  • 3-point gap control mechanism in the jaws ensures consistent proximal to distal alignment during firing.
• Solid, one-piece precision-machined anvil design allows tissue compress over the recommended 15 sec. period prior to firing.
• Natural articulation – no guessing how far to articulate (vs. lever-based, two-handed endocutters).
• True one-handed operation.
• Wide proximal-to-distal jaw aperture – easy tissue positioning and manipulation.
• Short grip span – greater comfort and ease of use.
• Safety lock-out prevents inadvertent firing of empty, or misloaded cartridges
• Wide range of cartridges to accommodate various tissue thickness, all with 6-row capability
• Compatible with all ECHELON ENDOPATH™ Cartridges
• Cut lines of 42mm (45mm staple line) and 57mm (60mm staple line)

Procedure applications:

• Bariatric
• Colorectal
• General surgery
• Gynecologic
• Thoracic
• Urologic

Site References

* Superior is defined as fewest malformed staples. Thick tissue defined as 3mm to 5mm as measured with a tissue compression measuring device set at 8g/mm² pressure. Study conducted in a porcine model. ECHELON FLEX 60mm Stapler with Green Cartridge (88 staples per cartridge) vs ENDO GIA Universal with 60mm Green Roticulator Stapler (90 staples per cartridge). Malformed staples are determined by the count of malformed staple legs divided by 2.¹

Ethicon Endo–Surgery Approach to Tissue Management

Maintaining Respect for Tissue
Respect for tissue is at the heart of everything we do at Ethicon Endo-Surgery, Inc (EES). In the 19th century, Dr. William Halsted defined a set of interrelated principles for safe and effective surgery. He stressed the importance of hemostasis, adequate blood supply, and the gentle handling of tissue. It is these principles that help drive our approach to developing advanced surgical devices.

Those principles haven’t changed. However, with the evolution of surgery, techniques of interacting with tissue have become more complex. For these reasons, we at EES are constantly working to deepen the understanding of living tissue dynamics, and to design our devices to help surgeons reduce trauma associated with their use.

Understanding the Role of Compression
Compression is a critical factor in successful surgical stapling. Prior to stapling, applying compression over time exudes fluid from tissue, which helps ensure a more consistent thickness in the targeted tissue. After tissue is compressed, it is ready to accommodate a securely closed staple. Proper staple formation is necessary to achieve a leak-proof and hemostatic staple line.

Understanding Tissue Properties
At EES, understanding the properties of living tissue is fundamental to our approach to surgical stapling. Our staplers are uniquely designed to work with the properties of tissue to prepare it for staples.

Surgical stapling devices must deliver optimal tissue compression to achieve proper staple formation and successful clinical outcomes.

Achieving Optimal Compression
When it comes to comes to compression, as illustrated below, it is important to apply enough pressure to achieve good hemostasis and a leak-free anastomosis. However, it is also necessary to maintain control of the applied pressure to avoid potential injury to the tissue.

Our Approach to Compression

EES devices apply precompression, which exudes fluid from tissue prior to firing to create a smooth stapling surface. This helps ensure that staples form properly, which in turn contributes to optimal compression.

With EES devices, living tissue is compressed to adequate thickness before stapling to achieve optimal mechanical stapling effectiveness.

Learn more about surgeon, device and tissue interactions