Surgical stapler.

The surgical stapler most likely has a European history. To prevent spillage of bowel contents during abdominal surgery, the Hungarian surgeon Hümer Hültl developed the first known surgical stapler together with the engineer Victor Fischer in 1908 (Fig. 1)1,2. ... The stapler consisted of U-shaped steel wire staples. After stapling, the tissue had to be cut. The staples did not completely close to prevent tissue necrosis, but were left in a B shape after stapling to allow tissue perfusion. The Fischer–Hültl stapler took 2 h to reload with individual staples and weighed about 5 kg. The first operation using this stapler was a subtotal gastrectomy for gastric cancer. In 1920, Aladar Petz, who was trained by Hültl, developed a lighter version that used nickel–silver alloy staples and weighed 1 kg (Fig. 2)3. ... The Petz stapler gained in popularity and became the most used stapler for the next 40 years. An important modification was made by the German surgeon Friedrich, who developed replaceable cartridges preloaded with staples in 1934. Here, an exchange system comparable to that of surgical blades developed by Morgan Parker, as described earlier in this series, was introduced4.