A Post Market Study to Confirm the Safety and Performance of the Signia™ Stapling System.

This study will evaluate the use of Signia™ Stapling System using Signia™ Intelligent Loading
Units with Tri-Staple™ 2.0 Intelligent Reloads in indicated abdominal or thoracic procedures
(e.g., resection, transection of tissue, and creation of anastomoses). Subjects who meet the
eligibility criteria will be considered for study participation at a minimum of 10 sites and
will be followed up to and including 30 days post-operative. Overall the study is estimated
to progress for up to 24 months.

Inclusion Criteria:

1. Adults (male or female) between 22 and 80 years of age inclusive at the time of the
procedure.

2. The subject must be willing and able to participate in the study procedures and to
understand and sign the informed consent.

3. The subject is scheduled to undergo an indicated primary abdominal or thoracic
procedure for resection, transection and creation of anastomosis per the IFU where the
Signia™ Stapling System with Endo GIA™ with Tri-Staple™ Technology and Tri-Staple™ 2.0
Intelligent Reloads will be used per its IFU.Additionally, if considered appropriate
for the procedure only Medtronic buttresses can be used during the course of the
study.

3a. Thoracic procedures may include, but are not limited to wedge resection and lobectomy,
and may include video assisted thoracic surgery (VATS) or open procedures.

3b. Abdominal procedures may include, but are not limited to, laparoscopic sleeve
gastrectomy (LSG), laparoscopic Roux-en-Y gastric bypass (LRYGB).

Exclusion Criteria:

1. Subjects undergoing cardiac and vascular procedures.

2. The procedure is an emergency procedure.

3. The procedure is a revision/reoperation of a primary operation..

4. Any female subject who is pregnant. 4a. Females of child-bearing potential will be
required to undergo either a urine pregnancy test or serum pregnancy test during
Screening and confirmed on the day of operation (except for subjects who are
surgically sterile or are post-menopausal for at least two years) (USA only) and per
EU local requirements.

5. Any subject who is considered to be part of a vulnerable population (e.g. prisoners or
those without sufficient mental capacity).

6. The subject is unable or unwilling to comply with the study requirements or follow-up
schedule.

7. The subject has comorbidities which, in the clinical judgment of the Investigator,
will not be appropriate for the study or the subject has an estimated life expectancy
of less than 6 months.

8. The subject has been diagnosed with a bleeding disorder and/or is undergoing active
and not reversed anticoagulant treatment.

9. The subject is concurrently enrolled in another investigational drug or device
research study or has been enrolled in another study within 30 days of enrollment.

10. Pre-existing/chronic conditions specific to Tri-Staple™ 2.0 Reload contraindications
as described in the IFU.