Open vs Laparoscopic Staplers: Differences and When Each Is Used

Open and laparoscopic staplers do the same job: they compress tissue, place staples and, in cutters, divide the tissue. The difference lies in how the instrument reaches the tissue, and that difference drives almost every design decision.

Access Is the Main Difference

In open surgery the surgeon has direct access and a wide field of view, so the stapler can be larger and simpler. In laparoscopic surgery the instrument must pass through a narrow trocar and work inside the abdomen, so it needs a long shaft, a small head and, usually, a way to angle the jaws.

Open Staplers: Direct Access, Wide Range

Open staplers cover a broad group of tasks: linear cutting and closing, circular anastomosis, and specialist instruments for anorectal, urological and skin closure. Because the surgeon can place the instrument by hand, designs often focus on how the tissue is arranged before the stapler is committed.

• Sazo is a linear cutter with interlaced rows of titanium staples on each side of the blade path.
• L-Rec is a linear closer that clamps automatically and has a position pin at the tip, so tissue does not overflow past the end of the staple line.
• C-Anazone and C-Anazone-Tst are circular staplers for anastomosis, with the second adding a third staggered row.
• Pile F, Circumzone and Rhino serve haemorrhoid, circumcision and skin closure.

Browse them all under Open Staplers.

Laparoscopic Staplers: Built for Confined Spaces

Laparoscopic staplers have to do the same work through a small port. That brings three design priorities.

Articulation

The head must reach tissue from awkward angles. Endozone, for example, articulates through eleven detented positions to a maximum of 45° left and right, and a single firing handle both clamps and releases, so it can be driven with one hand.

Tissue Control

Tissue tends to creep out of the jaw as it closes. The textured Gecko Claw surface on Trizone GC is designed to resist both lateral and longitudinal movement, and the curved tip on Trizone GC Curved Tip goes around tissue in the low pelvis and behind a mobilised stomach.

Staple Pattern and Reload System

Trizone lays six rows of staples in three heights, tallest on the outside, so tissue is compressed gradually across the jaw. Tenzr is a stapling platform with a quench-hardened cutter head and calibrated reload heights. See the full list under Laparoscopic Staplers.

Reload Colours: Two Families, Two Codes

Laparoscopic reloads are colour coded by staple height. Within the FourZone range, the Trizone reloads run White, Purple and Black, while Tenzr runs White, Blue, Gold and Green. Because the two families use different codes, always read the selector page for the family you are using rather than assuming a colour means the same thing across brands.

Which One Does a Hospital Need?

Most hospitals need both. The mix depends on the case load: a centre doing a lot of laparoscopic colorectal or bariatric work will use more endoscopic reloads, while a centre with high open-surgery volume will use more linear and circular open staplers. Skin staplers and specialist instruments are used across both.

When comparing options, look at staple formation, tissue control, handling and the supply of reloads. Our guide to choosing a surgical stapler gives a practical checklist.

How Handling Differs in Practice

The experience of using the two types is different, and the differences are worth understanding before a purchase.

Reach and Visibility

With an open stapler the surgeon sees the jaws and the tissue directly. With a laparoscopic stapler the surgeon works from a screen, so a clear view of the jaw tip, a visible position indicator and a stable shaft matter. Stable articulation, without drift as the jaws close, is especially valuable in tight spaces.

Force and Fatigue

Closing the jaws on thick tissue takes force. Long laparoscopic shafts reduce mechanical advantage, so handle design, grip shape and firing mechanism affect hand fatigue in long lists. This is one reason powered platforms are considered for laparoscopic work. Our article on powered vs manual staplers reviews the published evidence.

Port Size and Reloads

Laparoscopic staplers are designed around a particular port size, and the reload cartridges are matched to the handle. Make sure your theatre stocks the handles and the full range of reload heights you expect to need, because a missing reload during a case is a serious inconvenience.

Where Each Type Is Common

• Open linear and circular staplers: open bowel surgery, anastomosis, anorectal procedures, urological work.
• Laparoscopic staplers: minimally invasive colorectal, bariatric, gynaecological and thoracic procedures.
• Skin staplers: closure of the skin after open or laparoscopic procedures.

Questions to Ask When Comparing Devices

1. Does the stapler hold tissue securely as the jaws close?
2. Is the staple line complete and even along its full length?
3. Is the head stable when articulated?
4. Are reloads easy to identify and to load?
5. Is the supply of reloads reliable in your region?

Talk to Our Team

If you would like help matching devices to your case mix, get in touch and we will be glad to help.

Continue Reading

• What Is a Surgical Stapler and How Does It Work?
• Powered vs Manual Surgical Staplers: What the Evidence Says
• Circular Staplers and Anastomosis: Why Clearance and Compression Matter

Frequently Asked Questions