Use of energy-based coagulative fusion technology and lung sealants during anatomic lung resection

Schuchert, Matthew J.; Abbas, Ghulam; Landreneau, Joshua P.; Luketich, James D.; Landreneau, Rodney J.

doi:10.1016/j.jtcvs.2012.06.001

Cited by 10 publications

(15 citation statements)

References 29 publications

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“…Clarifying the potential of VSS in these types of procedures may reduce the need to use a stapler, leading to a reduction in operative costs. 6) Our present results reveal that the ability of VSS sealing to maintain an adequate bursting pressure is satisfactory, as has been reported in a few previous studies. However, the long term durability of VSS remains to be clarified and is why we performed a ligature at a central site even in our patients in the VSS group.…”

Section: Discussionsupporting

confidence: 90%

“…In addition, compared with the ultrasonic devices, the Ligasure produces consistently lower temperatures that minimize thermal spread to approximately 2-4 mm. 6,8) In our present study, we observed no incomplete seals or thermal injuries among the patient cohort.…”

Section: Discussionsupporting

confidence: 48%

“…Schuchert and colleagues have also reported successful anatomic lung resection in 316 cases using a Ligasure. 5,6) However, there have been few reports of the perioperative advantage of VSS in comparison with conventional techniques without VSS.…”

Section: Discussionmentioning

confidence: 99%

“…4) Few clinical and experimental cases of a human anatomic pulmonary lobectomy have been reported to date. 5,6) Additionally, very few comparisons of peri-operative data from VSS treatments and conventional procedures using an electrocautery device and manual ligature have been documented for human pulmonary lobectomies. The purpose of our current study was to retrospectively determine if VSS can be safely used to divide the pulmonary vasculature and provide benefits over manual ligature and electrocautery methods during an adult pulmonary lobectomy.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of Using a Vessel Sealing System in a Human Pulmonary Lobectomy: A Retrospective Comparison of This Procedure with or without a Vessel Sealing System

Yoshida

Toishi

Eguchi

et al. 2014

ATCS

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Objective: Despite recent advances in video-assisted thoracoscopic lobectomy, some technical limitations still remain. Our current study purpose was to determine if the vessel sealing system (VSS) has utility in this procedure. Method: 112 patients who underwent an anatomic pulmonary lobectomy at our institute were evaluated retrospectively. The burst pressure of pulmonary vessels, which was divided into VSS (VSS group; n = 44) or manual ligature (ligature group; n = 53) groups, was measured experimentally in transected lungs. Perioperative clinical data was also retrospectively evaluated in patients treated with (VSS group) or without using VSS (n-VSS group).

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Feasibility of Using a Vessel Sealing System in a Human Pulmonary Lobectomy: A Retrospective Comparison of This Procedure with or without a Vessel Sealing System

Yoshida

Toishi

Eguchi

et al. 2014

ATCS

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“…As new models of VATS devices develop, it is expected that new devices will be applied to subsegmentectomy because the subsegmental vessels and bronchi are very thin and a conventional stapler is too large for use in subsegmentectomy. A recent paper described the usefulness of energy devices or an endostapler (25)(26)(27). In particular, one new device called the MicroCutter has a narrower shaft than that of other conventional endostaplers and a 5 mm stapler.…”

Section: Future Prospect Of Instruments In Vats Subsegmentectomymentioning

confidence: 99%

Video-assisted thoracoscopic subsegmentectomy for small-sized pulmonary nodules

et al. 2017

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Segmentectomy has been widely performed as one of the types of limited resections that are performed for the resection of small-sized lung nodules. Video-assisted thoracoscopic surgery has also been in demand as a minimally invasive surgery. Subsegmentectomy is a much more limited resection than segmentectomy, but the technique is complex because it requires keen anatomical identification of small pulmonary structures. Therefore, there has been little reported about subsegmentectomy in medical literature. The recent development of computed tomography is remarkable, and some reports describe three-dimensional computed tomography as providing useful information because it assists surgeons in the performance of thoracoscopic anatomical subsegmentectomy. The creation of an intersubsegmental line is a key process in subsegmentectomy, therefore, some methods have been reported. We have safely and accurately performed some video-assisted thoracoscopic subsegmentectomies for small-sized lung tumors, using the three-dimensional computed tomography simulation and creating the intersubsegmental line with the inflation-deflation technique. In this article, we describe the recent techniques and roles of video-assisted thoracoscopic subsegmentectomy, and offer prospects for this procedure with our clinical data. more anatomically detailed resection that can involve the dissection of hilar lymph nodes attached to the segment containing the tumor. Moreover, the oncological outcomes of segmentectomy in a propensity-matched study were comparable to those of lobectomy for patients with earlystage non-small cell lung cancer (6). Segmentectomy has thus become widely used worldwide (1). While wedge resection has been applied to smaller lung nodules located in peripheral parenchyma, segmentectomy has been applied to small-sized lung nodules that show not only GGOs, but also solid appearances located in deep parenchyma. Recent developed CT enabled the detection of small-sized pulmonary nodules containing GGO component. For such smaller pulmonary nodules, especially located in the deep parenchyma, subsegmentectomy may be an alternative procedure; this is because it is difficult to perform a wedge resection for hilum nodules located in the deep parenchyma and segmentectomy may be an excessive resection for appropriate surgical margins.The role of subsegmentectomy is therefore considered as an intermediate procedure between wedge resection and segmentectomy. Consequently, we have concluded that the best indications for subsegmentectomy are as follows: (I) lung tumors of indeterminate nature, but considered suspicious for malignancy; (II) planned resection of a cT1aN0M0 primary lung cancer tumor less than 2 cm in diameter, with a GGO ratio of greater than 80% by highresolution CT, in patients with good pulmonary function who are able to tolerate lobectomy ( Figure 1A,B,C); (III) compromised resection in patients who are considered to be poor candidates for lobectomy due to limited cardiopulmonary reserve or other organ failure; (...

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Energy-Based Ligation of Pulmonary Vessels: A Six-Year Experience With Ultrasonic Shears in Video-Assisted Thoracoscopic Lobectomy and Segmentectomy

White

Kucukak

Lee

et al. 2016

The Annals of Thoracic Surgery

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Use of energy-based coagulative fusion technology and lung sealants during anatomic lung resection

Abstract: The bipolar tissue fusion system provides a safe and effective technique for the division of the pulmonary arterial and venous branches during anatomic lung resection. Surgical sealants and buttressing adjuncts might reduce perioperative air leak potential.

Cited by 10 publications

References 29 publications

Feasibility of Using a Vessel Sealing System in a Human Pulmonary Lobectomy: A Retrospective Comparison of This Procedure with or without a Vessel Sealing System

Feasibility of Using a Vessel Sealing System in a Human Pulmonary Lobectomy: A Retrospective Comparison of This Procedure with or without a Vessel Sealing System

Video-assisted thoracoscopic subsegmentectomy for small-sized pulmonary nodules

Energy-Based Ligation of Pulmonary Vessels: A Six-Year Experience With Ultrasonic Shears in Video-Assisted Thoracoscopic Lobectomy and Segmentectomy

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