## 3 Results
### Powered Stapling System  
Both linear and circular powered stapling systems are commercially available (see Table 9). For linear systems, today, Ethicon and Covidien are the only manufacturers on the market offering powered surgical staplers. Ethicon has two powered stapling systems, one being the ECHELON CIRCULAR(tm) Powered Stapler (ECPS) already mentioned in the previous section. The other one is the ECHELON FLEX(tm) Powered Vascular Stapler (PVS) (Ethicon, Echelon Flex Powered Vascular Stapler) (PPS) (Ethicon, Echelon Flex Powered Vascular Stapler) (PPS) (Ethicon, Echelon Flex Powered Vascular Stapler) (PPS) (PPS) (PPS) has a powered actuation, meaning that the firing mechanism is no more controlled by the swing of a knob or the compression of a spring but through a battery providing power to an electro-mechanical system maneuvering the cutting element if present and the cartridge. The stapler has a curved anvil tip, an introducer-like cartridge body tip, and active articulation with high articulation angles to facilitate access in surgical procedures with small surgical spaces or difficult-to-reach vessels. Medtronic Covidien Signia(tm) Stapling System (SIG) is relatively more complex. Not only does it have powered actuation, but the articulation, opening, and closing of the end effector are also powered through electrical motors. The compression of the tissue is sensed thanks to a strain-gage transducer located on the shaft, providing indications to the surgeon through a display. Regarding circular powered stapling solutions, Ethicon produces the ECHELON CIRCULAR(tm) Powered Stapler (ECPS) (Ethicon, Echelon Circular Powered Vascular Stapler) (PPS). This represents the powered variant of the already-discussed ETHICON(tm) Circular Stapler product and shares most of its technical specifications, such as lumen diameter (available in four sizes), staple rows, open staple leg length, and closed staple height. The iDrive(tm) staplers provided by Covidien showed superior performance in terms of access, visibility, and ease of placement in the deep pelvis (PPS). \begin{table}
\begin{tabular}{p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt}} \hline \hline
**Brand** & **Commercial Name** & **Code** & **Diameter [mm]** & **Staple Height [mm]** & **No. Rows** & **Closed Staple Height [mm]** & **Staple Quantity** & **Surgery Application and Relevant Info** & **Reference** \\ \hline \multirow{3}{*}{SINOLINKS} & Disposable Hemorrhoidal Stapler & DHS B-32 & 32.0 & 4 & 2 & 1 & 32 & It has applications in Thermorbid surgery for the selective mucosa along the dentate line. & (Sinolinks, Dissposable Discruiler Stapler) \\ \cline{2-10}  & Disposable Hemorrhoidal Stapler & DHS C-32 & 32.0 & 4 & 2 & 1 & 32 & mucosa along the dentate line. & \\ \cline{1-1} \cline{2-10}  & Disposable Hemorrhoidal Stapler & DHS C-32 & 32.0 & 4 & 2 & 1 & 32 & It has applications in Thermorbid surgery for the selective mucosa along the dentate line. & (Medtronic, EEA(tm) & Hemorrhoid and Prolapse Stapler) \\ \hline \multirow{3}{*}{COVIDEN} & EEA(tm) & & & & & & & & \\  & Hemorrhoid and Prolapse Stapler with DST Series(tm) & & & & & & & & \\  & Technology & & & & & & & & \\ \hline \multirow{3}{*}{ETHICON} & PROXIMATE(tm) & & & & & & & (Ethicon, PROXIMATE(tm) & PPH \\  & Premontidial Stapler Set & & & & & & & & \\ \cline{1-1} \cline{2-10}  & Single-Use Primordial Stapler & PPHD32 & 32.5 & 4.3 & & & & (Golden Stapler, Single Use & Hemorrhoid Stapler) & (Golden Stapler, Single Use Circular Stapler) \\ \cline{1-1} \cline{2-10}  & Single-Use Primordial Stapler & PPHD34 & 34.5 & 4.3 & 2 & 0.8 & 32 & It has applications in Thermorbid surgery. & Hemorrhoid Stapler \\ \cline{1-1} \cline{2-10}  & Circular Stapler & PPHD36 & 36.5 & 4.5 & & & 36 & (79) \\ \hline \hline \end{tabular}
\end{table} 
Table 8: Hemorrhoidal stapler characteristics. Both the ECHELON FLEX(tm) Powered Vascular Stapler (PVS) and the Covidien Signia(tm) Stapling System (SIG) have been extensively validated by the scientific community.