Thoracoscopic‐assisted lung lobectomy in cat cadavers using a resorbable self‐locking ligation device

Abstract

Objective: To compare the maximum pressure sustained by airways sealed with a resorbable ligation device (LigaTie) and with thoracoabdominal (TA) staples during thoracoscopic-assisted hilar lung lobectomies. Study design: In situ cadaveric study. Animals: Ten feline cadavers. Methods: Twenty lung lobectomies were performed with either a LigaTie or a TA stapler (n = 10 per group) by using a thoracoscopic-assisted technique. Procedures were randomly performed on the cranial lung lobes only. The distance between the ligation and the hilus was measured on each specimen. Airway pressures were tested to a maximum pressure of 40 cmH 2 O. Results: All LigaTie sites reached a maximum airway pressure without leaking and were easily placed at the hilus. Four of 10 TA stapled sites leaked at a mean pressure of 22 cmH 2 O (P = .010). All leaks occurred when the TA staple line was >5 mm from the hilus; no leaks occurred when the TA staple line was ≤5 mm from the hilus (P < .001). No difference was found between fresh and frozen cadavers (P = .483) or right vs left lung lobe (P = .284). Conclusion: Lung lobectomies were consistently performed at the hilus only when the LigaTie was used. Lung lobectomies were less likely to leak when performed with the LigaTie rather compared with TA staples. Clinical significance: The LigaTie may be an effective alternative for lung lobectomies at the pulmonary hilus in cats and small breed dogs. Our findings provide justification for additional clinical testing.

Comparison of macroscopic resorption time for a self‐locking device and suture material in ovarian pedicle ligation in dogs

“…A resorbable self-locking device for surgical ligation that facilitates a safer and easier surgical procedure is being tested. [1][2][3][4][5][6][7] The material used in the device, a block copolymer of glycolic acid and trimethylene carbonate (TMC), is equivalent to the suture Maxon, a monofilament resorbable suture which was introduced in the mid-1980s. 8 The degradation and resorption of the Maxon suture is well described [9][10][11][12][13][14][15] and this resorbable suture is one of several alternatives for ligation of the canine ovarian pedicle.…”

Thoracoscopic hilar lung lobectomy in two dogs

“…The previous studies described that the patients were positioned in the lateral recumbency for the thoracoscopic lung lobectomy 7–23. In our study, the patient’s position was left semirecumbency for approaching the right medial lobe, and three portals were formed at the costochondral junction level in the third, fifth and seventh intercostal spaces.…”

“…Especially, leaving malignant lesions in the surgical margin might cause the dissemination and regrowth in the thorax. Therefore, thoracoscopic lung lobectomy is limited to be indicated for small animals 7–21 23. Our study suggests that use of intracorporal ligation, haemoclips and endoloop achieves thoracoscopic hilar lung lobectomy in small‐breed dogs.…”

“…EndoGIA stapler is generally used for humans with congenital lung lesions 1–6. Previous studies have reported that EndoGIA or TA stapler is used for lung lobectomy with the thoracoscopic surgery or video‐assisted thoracic surgery (VATS) in dogs 7–23. However, those staplers are too large to be inserted and manipulated in the thorax of small‐sized dogs.…”

“…[1][2][3][4][5][6] Previous studies have reported that EndoGIA or TA stapler is used for lung lobectomy with the thoracoscopic surgery or video-assisted thoracic surgery (VATS) in dogs. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] However, those staplers are too large to be inserted and manipulated in the thorax of small-sized dogs. In addition, in case of the lesions close to the lung hilum, the use of the staplers has the potential risk for leaving the lesions.…”