Ultrasonic surgical aspirator for lung resection

The ultrasonic surgical aspirator was originally developed for neurosurgical procedures and hepatic resections. Ultrasonic vibration at the tip of the instrument results in lysis of the parenchymal cells, leaving more resistant fibrous tissue such as blood vessels and bronchi intact and, thus, minimizing blood loss. We have studied the feasibility of applying the ultrasonic surgical aspirator for segmental and subsegmental lung resection for primary and metastatic neoplasms of the lung. Over the past 5 years, 27 patients underwent segmental or limited lung resection using the ultrasonic surgical aspirator. Except for prolonged air leak in 6 patients postoperatively, no other serious morbidity was noted. We observed several advantages: (1) the ultrasonic surgical aspirator dissects out the pulmonary vessels and bronchi, allowing the surgeon to perform segmental and subsegmental resections with minimal blood loss, (2) it permits lung-sparing operation for centrally located tumors that would otherwise have required lobectomy, and (3) it allows direct visualization of lung parenchyma during dissection, thus assuring grossly adequate margins.