Surgical Staplers and Staples

Surgical staplers are generally made of plastic and loaded with a disposable cartridge of surgical staples. The staplers come in both reusable and disposable models. They resemble construction or industrial staplers and can insert and close several staples at once.

Doctors may use these devices internally to seal tissue during surgery. They are useful in minimally invasive surgery because they require only a narrow opening and can quickly cut and seal tissue and blood vessels. Medical professionals also use staplers externally to close skin under high tension, such as on the skull or the trunk of the body.

Doctors frequently use surgical staplers to close incisions in the abdomen and uterus during cesarean deliveries, or C-sections, since the staples allow people to heal faster and reduce scar tissue. Surgeons may also rely on surgical staplers when removing part of an organ or cutting through organs and tissue inside the body.

Providers also use surgical staplers to connect or reconnect internal organs within an organ system. Doctors frequently use these staplers for surgeries involving the digestive tract, including the esophagus, stomach and intestines. In these operations, surgeons remove part of these tube-like structures and reconnect the remaining portions.

Patients must pay special attention to medical staples in the skin to avoid infection. A 2022 study reviewed the surgical site infection rate of wound closure using staples versus sutures in elective knee and hip arthroplasties. The researchers found a potentially higher risk of surgical site infection in patients with staples compared to sutures, especially for patients with hip replacements.

Always follow your doctor’s instructions and do not remove any dressings until it’s safe to do so. Rinse the site twice daily to keep it clean. Your doctor will tell you how and when to dress the wound to prevent infection.

Removing Surgical Staples

Surgical staples usually remain in place for one to two weeks, depending on the type of surgery and the placement of the staples. In some cases, doctors may not remove internal staples. They are either absorbed or become permanent additions to hold internal tissue together.

Removing surgical staples from the skin is generally not painful, but only a health care professional should remove them. Never attempt to remove surgical staples on your own.

Removal requires a sterile setting and a specialized surgical staple remover or extractor. The device spreads one staple at a time, allowing the doctor to gently work it out of the skin.

If the wound has not completely healed, a doctor will remove every other staple, and the patient will schedule a second appointment to remove the rest.

Surgical staplers compress tissue, connecting two pieces of tissue with staggered rows of B-shaped surgical staples and, in some models, cutting away excess tissue to create a clean closure of the surgical wound.

There are various designs for different types of surgeries, with most categorized as either linear or circular.

When using linear staplers, the surgeon uses the handles at one end to close the “jaws” of the stapler at the other end over the tissue. When the surgeon fires the stapler, a row of staples binds the tissue together, and a blade cuts the tissue between the staples. The process seals the open wound to prevent bleeding.

Surgeons use linear staplers to connect tissue during minimally invasive surgeries or to remove an organ. However, surgeries involving the digestive tract from the throat to the colon often require circular staplers.

Circular staplers fire two staggered rows of staples from a circular cartridge. This circular layout allows the stapler to connect two sections of the intestine, or another tube-like structure, after surgeons remove a portion. The staples cause tissue to pinch up as rings or donuts between the staples. A built-in blade then slices off the overlaying tissue, sealing the new connection.

Surgeons watch the closed wound for about 30 seconds to make sure they have properly squeezed the tissue together and confirm that there is no bleeding.

What Are Surgical Staples Made Of?

Common materials for surgical staples include stainless steel and titanium. These are both strong metals that tend to cause few problems for patients in surgical procedures.

However, doctors frequently use plastic staples for people with metal allergies or to reduce scar tissue.

Staples made from plastic or metals don’t dissolve like many sutures, so doctors and patients must pay close attention to prevent infection.

Manufacturers also create specialized staples for reabsorption into the body using a biodegradable material called polylactic-co-glycolic acid (PLGA). Cosmetic surgeons often use PLGA staples because, like plastic staples, they result in less scarring.

Medtronic and Johnson & Johnson’s Ethicon division are the two largest surgical stapler manufacturers. Together, they have an estimated market share of about 48.6% as of 2025, according to an analysis by Future Market Insights. 3M also manufactures skin staplers sold in the United States.

In 2025, the estimated global industry value for surgical staplers and staples was roughly $3.7 billion, with most sold in North America and Europe.

Some people who have suffered serious injuries due to malfunctioning staplers have filed surgical stapler lawsuits. In addition, the U.S. Food and Drug Administration (FDA) has issued safety communications and recalls for various surgical staplers over the years.

2019 Ethicon Recall

Johnson & Johnson subsidiary Ethicon recalled 434,614 surgical staplers in April 2019 over concerns that they might not fire with enough force to completely form staples.

The FDA branded the recall as Class I, the agency’s most serious type. The FDA warned in a statement that the devices could cause serious injuries or death.

The recall affected the company’s Curved Intraluminal Staplers used in gastrointestinal tract surgeries.

Ethicon reported that two patients had been injured by the devices, according to the FDA. In both cases, the devices misfired, cutting portions of the rectum. Misfires or other malfunctions can prolong operations or require doctors to perform unplanned surgery to correct the damage.

The FDA warned that the misfires could increase complications from surgical staplers, including the risk for bleeding, infection and permanent organ damage.

2015 Ethicon Recall

Previously, in 2015, Ethicon recalled 6,744 reload cartridges for its Echelon Endopath devices. Ethicon manufactured these devices for use in gynecologic, urologic, thoracic, pediatric and general minimally invasive surgeries.

The company reported that an inspection had found the surgical staplers’ cartridges may not insert a complete line of staples when fired.

2018 and 2019 Medtronic Recalls

Medtronic issued two recalls of its Endo GIA staplers and staple cartridges from select production lots in 2018 and 2019. Both recalls involved possible missing components. The company said the defects could affect staple alignment and lead to serious complications.

At least five people were injured by staplers included in the 2018 recall, according to the company. The 2019 recall involved defects in staple cartridges that Medtronic spotted while performing quality tests during the manufacturing process. The company reported “no confirmed complaints” about the devices from doctors or patients.

Complications From Surgical Stapler Malfunctions

Surgical stapler and staple malfunctions have resulted in thousands of serious complications. Malfunctions can prolong surgical procedures, keeping a patient under anesthesia longer than planned, which can present additional complications.

Staple injuries may cause bodily damage that doctors can only correct through other surgical interventions.

In addition to its actions on product recalls, the FDA began tightening restrictions and reporting safety concerns over surgical staplers in 2019. It issued new guidance to doctors and hospitals about properly using the staplers, took steps to reclassify certain surgical staplers from low- to moderate-risk devices and reported tens of thousands of previously unknown cases of stapler malfunctions and injuries.

The new classification would require premarket review and clearance of the devices from the FDA before manufacturers could sell them.

The FDA actions followed a series of surgical stapler problems discovered earlier in 2019. KFF Health News reported that the FDA recorded more than half of all surgical stapler malfunctions from 2011 through 2018 in a hidden system known as an “alternative summary reporting program” instead of a database accessible by the public. The hidden database included over 56,000 reports.

The FDA consolidated the two databases so the public could view all of the reports. The total number of reported surgical stapler malfunctions over the eight-year period rose from 41,000 to nearly 110,000.