This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.

Pioneers of Surgical Stapling
Before the invention of the first surgical staplers some inroads where towards the development of automated suture devices and clamps that allowed surgeons to manipulate the tissues to obtain proper suture placement. These devices, some of them based on the first sewing machines did not survive the test of time.
The first true and successful surgical stapler was developed in 1908 by Dr. Hümer Hültl (1868 – 1940) in Hungary. Although heavy and cumbersome, this stapler had some of the concepts that are found today in modern surgical staplers: “B" shaped staples, staggered rows of staples, and attention to the avoidance of leakage through the staple line. Hültl’s stapler placed four staggered rows of wire staples. Today’s surgical staplers usually place two or three staggered rows of surgical titanium staples. History tells us that Dr. Hültl sold only 50 of his instruments because of high price, difficulty in reloading, and most importantly, the reticence of surgeons to adapt to this new technology.
In 1920 the Hültl stapler was improved by Dr. Aladar Petz (1888 – 1956), also Hungarian. The “Von Petz stapler” was lighter, easier to use, used silver staples, more affordable in price, and sold all over the world, allowing for surgeons to see this new technology in use.
Unfortunately, the Von Petz stapler could only be used once in surgery, as it needed to be cleaned, reloaded, and sterilized before reusing it. 1934 Dr. H Friedrich of Ulm Germany invented the replaceable cartridge, so that a surgical stapler could be reused multiple times in one surgery. This opened the way for a “triangular” type end-to-end anastomosis that until this time could not be performed. Also, Dr. Friedrich’s stapler had adjustable tissue compression.
Personal note: In 1987 I had the opportunity to scrub in one of the last uses of a Von Petz stapler in surgery (Chile, South America). This instrument was used to perform an “in toto” stapling and transection of the pulmonary hilum for a pneumonectomy. The instrument, after almost 40 years of its development, performed flawlessly. Dr. Miranda
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The history of surgical stapling [1] ; [2]; [3]; [Video]
Sources
1. "Surgical stapling" Mallina, R F 1962 Scientific American 207, 48
2. “Science of Stapling: Urban Legend and Fact” Pfiedler & Ethicon EndoSurgery
3. “Cholecystointestinal, gastrointestinal, enterintestinal anastomosis, and approximation without sutures” Murphy JB. Med Rec (1892) 42: 665
4. “Study of Tissue Compression Processes in Suturing Devices” Astafiev, G. (1967 (USSR Ministry of Health, Ed.)
5. “Rese?as Hist?ricas: John Benjamin Murphy” Parquet, R.A. Acta Gastroenterol Latinoam 2010;40:97
6. “The Science of Stapling and Leaks” Baker, R. S., & et al. (2004) Obesity Surgery, 14, 1290-1298.
7. “John Benjamin Murphy – Pioneer of gastrointestinal anastomosis”Bhattacharya, K., & Bhattacharya, N. (2008). Indian J. Surg., 70, 330-333.
8. “The Story of Surgery” Graham, H. (1939) New York: Doubleday, Doran & Co.. Inc.
9. “Compression Anastomosis: History and Clinical Considerations”Kaidar-Person, O, et al, e. (2008) Am J Surg, 818-826.
10. “Current Practice of Surgical Stapling”Ravitch, M. M., Steichen, F. M., & Welter, R. (1991) Philadelphia: Lea& Febiger.
11. “Aladar Petz (1888-1956) and his world-renowned invention: The gastric stapler” Olah, A. Dig Surg 2002: 19; 393-399