Detecting the Limits of Bronchial Closure Methods in an Animal Model

Abstract

This trial suggests that manual suture closure using an appropriate technique and monofilament materials is as safe as the stapler.

Reinforcement Bronchial Stump Increases Early Mechanical Integrity: an ExVivo Experimental Study

“…Some authors have reported that mechanical staplers are superior to manual suture for bronchial closure (13), while others found no difference (11). In an ex vivo study LUDWIG et al found a significantly higher air pressure resistance when the bronchus was closed with a mechanical stapler compared to manual suture (14).…”

Hilar closure using staplers or Hem-o-lok clips in a rabbit model

“…Combinations described in the literature include the use of manual intracorporeal suturing for bronchial closure along with vessel-sealing of the pulmonary vasculature [1,3] or the use of 5 mm endoscopic clips on the bronchus [2,3]. Although intracorporeal suturing techniques have been demonstrated to have similar leak pressures to endoscopic stapling devices, the increased surgical time may result in increased morbidity and cost associated with surgery [12,13]. A rapid and secure alternative to intracorporeal suturing techniques in small patients undergoing VATS lung lobectomy might decrease anesthesia and surgical time, which is especially appealing in this cohort of challenging patients that are often afflicted with significant pulmonary disease.…”

Pagrindinio broncho bigės rankinių siūlių atsparumas slėgiui

“…Šiuo metodu galima imituoti visus operacinėje atliekamus chirurginius veiksmus: paruošti tinkamo ilgio ir formos pagrindinio broncho bigę, labai tiksliai perverti siūlus. Eksperimentuojant nustatytas labai įvairus (nuo 33 iki 200 mmHg stulpelio) pagrindinio broncho bigės siūlės atsparumas slėgiui (7,(16)(17)(18)(19). Tai galima paaiškinti metodikos savitumais ir subjektyviais veiksniais, pvz., siūlės suveržimo laips-niu.…”