Colorectal Anastomosis with ECHELON CIRCULAR Powered Stapler

Mr. Ian Jenkins from St. Mark´s Hospital in London discusses anastomotic leaks, forming the circular anastomosis, and how ECHELON CIRCULAR Powered Stapler may produce significant benefits overall.

Echelon Circular Powered Stapler - Ian Jenkins, St Marks London

Ethicon, part of the Johnson & Johnson Medical Devices Companies, has made significant contributions to surgery for more than 100 years, from creating the first sutures, to revolutionizing surgery with minimally invasive procedures. Our surgical technologies and solutions include sutures, staplers, energy devices, trocars and haemostats along with interventional ablation, robotics and digital solutions.

Digital Solutions

Giving surgeons additional information to support their clinical decision-making has the potential to drive the next surgical revolution. Our digital surgery ecosystem will bring together the collective value of Next Generation Robotics and Instrumentation; Advanced Imaging; and AI-powered Digital Solutions.

Digital Solutions

Ethicon Plus Antibacterial Sutures

Triclosan-coated sutures are supported by evidence-based recommendations from a number of global health authorities and technology assessment bodies as part of the SSI prevention bundle.2-6**

Ethicon Plus Antibacterial Sutures

News & Events

Teaser Image

Ethicon Plus Sutures Become First and Only Sutures with Antibacterial Protection Recommended for use in NHS by NICE Medical Technologies Guidance

Teaser Image


Teaser Image

Ethicon Addresses Challenges of Surgical Bleeding to Help Surgeons Control Them More Efficiently and Reduce Impact on Patients

Teaser Image


Ethicon Customer Support

Our experienced medical professionals understand your unique challenges and make it easy for you to get the information you need. From technical and product assistance to MRI and allergy information and more—just contact us.

Ethicon Customer Support

* Review of 3,006 cases between 2012 and 2016 from the US Premier Healthcare Database. Data assessed included length of stay, total hospital cost, supply cost, room & board cost, incidence of transfusion, and incidence of hemostasis‐related complications; all p ≤ 0.05.

** CDC, WHO, ACS/SIS, NICE, and KRINKO guidelines on reducing the riskof surgical site infections are general to triclosan‐coated sutures and are not specific to any one brand. Recommendations for different types of surgery may not be consistent across authorities.

*** Impact of the Novel Powered Circular Stapler on Risk of Anastomotic Leakage in Colorectal Anastomosis. A Propensity Score‐ Matched Study. [ECHELON CIRCULAR 1.7% (1/60) vs. manual circular 11.8% (14/119), p=0.022]

# Finite element‐based computational simulations (FEA) on simulated porcine tissue measuring tissue compression after approximation and staple formation, comparing average standard deviation of 5.481 for 2D staples to 5.109 for 3D staples (n=37, p<0.05). 

^ Advancing staple line security with fewer leakage pathways and less malformed staples. Fewer leakage pathways: benchtop testing in porcine tissue ≤ 30mmHg (26mmHG average pressure experienced during typical leak test), comparing Ethicon ECHELON+ Stapler PSEE60A with GST Reloads GST60B to Medtronic Signia™ and Endo GIA™ Staplers with Tri-Staple™ Reloads EGIA60AMT. Cumulative number of leaked tests (0/30), (7/30) & (9/30) respectively, n=30, p < 0.05. Fewer malformed staples: benchtop testing in 3.3mm and 4.0mm porcine tissue comparing malformed staples between ECHELON+ Stapler with GST Reloads (GST60B, GST60T) to Medtronic Signia™ Stapler with Tri-Staple™ Reloads (EGIA60AMT, EGIA60AXT) and Endo GIA™ with Tri-Staple™ Reloads (EGIA60AMT, EGIA60AXT). Percentage malformed results: 1.14% vs 4.28%, p < 0.05.

† In bench top tests comparing mean number of insertions for 5mm trocars out of 10 insertions with a quality index score of 92 or higher for Ethicon 2B5LT (6.4) to Applied Medical C0Q04/CFR03/CTR03/CTF03/CFI13 (0.5) and Covidien NB5STF/VS101005 (0.4), p<0.05. In bench top tests comparing mean number of insertions for 12mm trocars out of 15 insertions with a quality index score of 92 or higher for Ethicon 2B12LT (11.6) to Applied Medical CTF73/C0R29/CFI83/CFF73/CFR73/C0R47 (0.4) and Covidien NB12STF/VS101012P (1.6), p<0.05. Quality index score of 92 or higher indicates a less than 20% chance of having to re‐wipe the endoscope lens due to trocar induced smudging.

¶ Based on metrology data, ENSEAL X1 Curved Jaw Tissue Sealer has a 16% (or 3.4mm) longer jaw than LigaSure™ Maryland (LF1937) (p < 0.001) and ENSEAL X1 Curved Jaw Tissue Sealer has a 9% (or 1.15mm) wider jaw aperture than LigaSure™ Maryland (LF1937) (p < 0.001).

§ Efficiently captures and filters 99.999% of particulates and microorganisms of 0.1 to 0.2 microns and performs quiet at 50 +/‐ 10 dBa per IEC 60601‐1 at 1 m, with [59.2 dBA in open mode] [and/or] [51.9 dBA in lap mode] at 1 m.

1. Miller DL, Roy S, Kassis ES, Yadalam S4, Ramisetti S4, Johnston SS5.. Impact of Powered and Tissue-Specific Endoscopic Stapling Technology on Clinical and Economic Outcomes of Video‐Assisted Thoracic Surgery Lobectomy Procedures: A Retrospective, Observational Study. Adv Ther. 2018 May;35(5):707‐723.

2. Berrios‐Torres SI, Umscheid CA, Bratzler DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017;152(8):784‐791.

3. Ban KA, Minei JP, Laronga C, et al. American college of surgeons and surgical infection society: surgical site infection guidelines, 2016 update. J Am Coll Surg. 2017;224(1):59‐74.

4. NICE Guideline Updates Team (UK). Surgical site infection: prevention and treatment. NICE website.
Accessed Nov 16, 2020.

5. World Health Organization. Global guidelines for the prevention of surgical site infection.‐eng.pdf?sequence=8. Published November 2016. Accessed Nov 16, 2020.

6. Prevention of postoperative wound infections. Recommendation of the Committee for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. Bundesgesundheitsbl. 2018;61(4):448‐473.

7. Pla‐Martí V, Martín‐Arévalo J, Moro‐Valdezate D, et al. Impact of the novel powered circular stapler on risk of anastomotic leakage in colorectal anastomosis: a propensity score‐ matched study. Tech Coloproctol. 2020.‐020‐02338‐y. 

8. Ethicon, 500561940A.7 Silhouette Tissue Compression Simulation [Claims – EU], Oct 2020.

9. Ethicon, 500632160A Design Intent for Echelon Contour Curved Cutter, Jan 2021, Data on file.

10. Ethicon, PRC096436A Ex-Vivo Comparison of Staple Line Leak Pressure: Echelon Flex Powered Plus Stapler with GST vs Endo GIA and Signia with Tri-Staple Technology, Aug 2020, Data on file. Ethicon, PRC096858A Evaluation of Malformed Staples in Thick Tissue for Claims: Echelon Flex Powered Plus Stapler with GST vs Endo GIA and Signia with TriStaple Technology, Aug 2020, Data on file (159504-201117 EMEA).

11. Ethicon, PRC056628 Hermes Competitive Quality Index Testing, Oct 2012, Data on file.

12. Ethicon, PRC049012D Competitive Tests of Access System Quality Image, Oct 2012, Data on file.

13. Ehticon, Project Floyd: Claims Metrology Report, June 2018, PRC079564B.

14. Ethicon, Floyd Relaunch Claims Metrology, June 2020, PRC095763A.

15. As per Instructions For Use (131252-200127, 131256-200722, 131337-200128).

16. Ethicon, ENG‐RPT‐704 Filter Physical characteristics comparison with predicate device filter, Oct 2019, Data on File.

17. Ethicon, ENG‐RPT‐753, MESE1 competitive sound test report, Feb 2020, Data on File.

18. Periyanayagam U,  et al. New Colorectal Cancer Diagnoses Fall by One-Third and Colonoscopies Grind to a Halt During Height of COVID-19. Komodo Health. 2020.


182541-210708 EMEA