According to the reporter, during an open total gastrectomy r-y procedure, for lifting the jejunum up, they connected the reload to the adapter and checked the jaws opening/closing with no problem.Then the surgeon tried to fire the device, however the clamp cover did not advance from the proximal end of the reload and could not fire the device.The display screen showed indicator of the used shell attached.The surgeon removed the cartridge from the tissue with no problem.They replaced it with another handle and a new shell, and connected the same reload; however the surgeon could not fire the device.They replaced it with another reload (the second one); however the surgeon still could not fire the device.They replaced the handle with a third one and another new shell (the third one), and connected the reload (the second one) however the surgeon could not fire the device.They replaced the handle with a different one (fourth handle), and connected the reload (the second one), however the surgeon could not squeeze the handle and could not fire the device.They replaced the device with another new reload (third one), and connected the same handle (fourth one), and the firing was successful.The surgical time was extended by more than 30 minutes.There was no patient injury.
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