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

The Annals of Thoracic Surgery
Abby WhiteScott Swanson

Abstract

Mechanical staplers are widely employed in minimally invasive anatomic lung resections, but have limitations when managing smaller pulmonary arterial and venous branches. Published data is lacking regarding the safety and efficacy of pulmonary vessel ligation using ultrasonic shears. We describe a single-surgeon experience employing ultrasonic shears for the ligation of pulmonary vasculature during lobectomy and segmentectomy, primarily in the setting of video-assisted thoracic surgery (VATS) resection. A retrospective chart review was conducted for all patients, who underwent anatomic resection, between 2008 and 2014. Charts were divided into 2 groups based on method of ligation (energy based or conventional). Dictated operative reports were reviewed and patient demographics, tumor characteristics, and complications were recorded. Ultrasonic shears were used for pulmonary vessel ligation (5 to 6 mm) in 82 of 283 anatomic resections. A total of 118 vessels were ligated with ultrasonic shears. The majority of patients (83%) in the energy-based ligation group underwent VATS resection. There were fewer complications in the energy-based ligation group (26% vs 38%; p = 0.05); however, rates of intraoperative transfusion, prolonged a...Continue Reading

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Citations

Nov 6, 2020·Interactive Cardiovascular and Thoracic Surgery·Eric GoudieMoishe Liberman
Nov 5, 2019·The Journal of Thoracic and Cardiovascular Surgery·Moishe LibermanUNKNOWN VATS PA Study Working Group
Apr 9, 2021·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Hassan A Khalil, M Blair Marshall

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