Background: The advent of surgical staplers has significantly transformed the landscape of lung resection surgery. By enabling faster and more precise closure of tissues, surgical staplers have reduced operative times, minimized blood loss, decreased rate of postoperative air leak and improved overall surgical outcomes for patients undergoing lung resections. We recently began using a new surgical stapler. We analyse and compare the outcomes of this stapler with an existing surgical stapler to compare postoperative outcomes between the AEONTM and SigniaTM surgical staplers in patients undergoing video-assisted thoracoscopic surgery (VATS) pulmonary wedge resection. Methods: This retrospective cohort study analysed the medical records of patients who underwent VATS lung wedge resection at our institution between 2018 and 2024. Signia was our predominant stapler between 2018 and 2021. AEON was the predominant stapler between 2021 and 2024. Patients were divided into two groups based on the type of stapler used. Statistical analyses included Chi-squared, t-tests, and Mann-Whitney U tests. Multivariate analysis was conducted for unbalanced outcomes between the two groups to control for the potential confounders. Results: Of the 79 patients, 43.0% underwent resection with AEON and 57.0% with Signia. Baseline demographics were largely comparable; however, AEON patients were more frequently female (82.4% vs. 55.6%, P=0.02) and more likely to undergo resection for primary lung cancer (61.8% vs. 33.3%, P=0.02), whereas Signia patients more often had metastatic disease (46.7% vs. 20.6%, P=0.02). Smoking history did not differ significantly between groups (52.9% vs. 53.3%, P>0.99). Postoperative complication rates, including prolonged air leak, bleeding, pneumothorax, reintervention, reoperation, and readmission, were low and did not differ between groups (all P>0.99). Median length of stay (LOS) was 1 day with AEON and 2 days with Signia (P=0.08); in adjusted analysis including sex and pathology, stapler type was not independently associated with LOS (P>0.05). The number of staplers load per case was similar (4 vs. 3, P=0.39). Conclusions: Both the AEON and Signia staplers are safe and effective for use in VATS lung resection, with comparable postoperative outcomes, indicating that no statistically significant differences were observed between devices.
