Best way to remove staples

[RA resident]

Hey guys

How do y'all remove surgical staples from your specimens? I'm talking about those laparoscopic staples that look like a capital B in profile.

At our program we just pluck them out with fine tweezers, which also rips out a bunch of tissue. Today my lung cancer case was right on the staple line & try as I might I could NOT preserve that tissue, I think the margin shrunk by at least 2-3 mm with my manipulations, which might end up upstaging the patient 🙁 I asked the PAs and attending and everyone was just like "yup, that's life"

I'm just remembering the skin staple removers, which actually worked really well in opening up those rectangular staples. If there was one fine enough, you could use it to open the loops of the B staples and then coax it out of the tissue.

Give me ideas guys, I don't want this happening again.

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[Alteran]

Props to you for trying to remove the staples. I don’t bother. The tissue that is stapled through like that is completely toast for histology and I doubt it’ll look any good under the microscope. The PA, and I when I have to gross, just take some forceps and scissors and cut with the scissors as close to the staple line as I can and call it a day.

 

[Autopsy101]

Same technique here - cut as close to staples as possible, then ink margin.

 

[RA resident]

thanks for your comments. Guess I'll just try to relax about it

 

[LoaLoa]

I have worried about this, too. I know for a fact I’ve called parenchymal margins “positive” on lung wedges when the true margin (beyond the staple line) looked clear. I have learned to accept it, as I think it is pretty much universally understood that we have to trim off that staple line to look at the margin. It’d be interesting for an enterprising resident to look at the data and see if a positive wedge margin truly imparts a worse prognosis than one that is close. Maybe it doesn’t matter.