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Ann Thorac Surg 2004;77:1415-1418
© 2004 The Society of Thoracic Surgeons

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New technology

A new tissue-sealing technique using the ligasure system for nonanatomical pulmonary resection: preliminary results of sutureless and stapleless thoracoscopic surgery

^a Division of General Thoracic Surgery, Takarazuka Municipal Hospital, Hyogo, Japan
^b Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

Accepted for publication April 28, 2003.

^* Address reprint requests to Dr Shigemura, Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
e-mail: n-shige{at}blue.ocn.ne.jp

Abstract

PURPOSE: We present our initial evaluation of a new surgical technique of lung tissue sealing for nonanatomical pulmonary resection composed of sutureless and stapleless thoracoscopic surgery.

DESCRIPTION: Twelve patients who required therapeutic thoracoscopic pulmonary resection from April 2001 to April 2002 were recruited for this study. Resection of lung parenchyma was performed with an ultrasound-driven scalpel, and the cut end was sealed using LigaSure, a new bipolar system. Measurement of the cut surface after resection during the surgery and assessment of LigaSure sealing strength was performed.

EVALUATION: There were no deaths or major intraoperative complications. The mean operation time was 65 minutes, and mean hemorrhage volume was 46 mL. Average chest drain duration was 3 days, and average hospital stay was 6 days. One patient with a giant bulla and cut surface diameter of 50 mm experienced persistent air leak for 1 week. Late complications did not occur over the 8-month follow-up period.

CONCLUSIONS: Video-assisted thoracoscopic surgery pulmonary resection using LigaSure instead of staplers appears technically feasible and easy, and produces satisfactory preliminary results. Although further studies are required to confirm the sealing strength and reliability of LigaSure, this technique should be considered for use in nonanatomical pulmonary resections.

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