Comparing bipolar electrothermal device and endostapler in endoscopic lung wedge resection

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Surgical Devices

Background:

• Video-assisted thoracoscopy (VATS) is increasingly utilized in thoracic surgery.
• Newer devices, including endostaplers and bipolar electrothermal devices like Ligasure, are used for lung parenchyma sealing.
• Limited literature exists on the efficacy of Ligasure for pulmonary wedge resections.

Purpose of the Study:

• To compare the efficacy and safety of Ligasure-Atlas versus ETS Flex endostapler for pulmonary wedge resection in patients with solitary pulmonary nodules (SPN) via VATS.
• To evaluate surgical outcomes, complications, and costs associated with each device.

Main Methods:

• Retrospective analysis of 44 consecutive patients undergoing VATS for non-verified SPN.
• Pulmonary wedge resection performed using either Ligasure-Atlas (22 patients) or ETS Flex endostapler (22 patients).
• Comparison of demographic data, operative parameters (time, fluid loss), postoperative outcomes (hospital stay, drainage time), complication rates, and instrumental costs.

Main Results:

• Both Ligasure-Atlas and ETS Flex endostapler were effective for pulmonary wedge resection.
• Ligasure-Atlas group showed comparable outcomes in terms of operation time, hospital stay, drainage time, and fluid loss.
• Ligasure-Atlas resulted in significantly lower instrumental costs (367 euro vs. 756 euro) and a similar low complication rate (2 vs. 1).

Conclusions:

• Ligasure-Atlas is a safe, easy-to-use, and eligible device for pulmonary wedge resection in VATS.
• This method offers a cost-effective alternative to endostaplers for resecting solitary pulmonary nodules.
• Further research with larger cohorts may further elucidate the benefits of Ligasure in thoracic surgery.