Massive haemothorax after pulmonary endostapling preloaded with bioabsorbable tissue reinforcement material

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Complications

Background:

• Reinforced endostapling is utilized to prevent air leaks after lung surgery.
• Bioabsorbable tissue reinforcement materials are commonly used with endostaplers.

Observation:

• A 58-year-old woman with idiopathic interstitial pneumonia underwent thoracoscopic lung biopsy.
• The procedure involved an endostapler preloaded with bioabsorbable tissue reinforcement.

Findings:

• The patient developed a lethal hemothorax on the day following the lung biopsy.
• Emergency surgery revealed the bleeding source as an intercostal artery adjacent to the surgical stump.
• Operative findings indicated the reinforcement material abraded the chest wall during respiratory movements.

Implications:

• Reinforced endostapling, while preventing air leaks, may pose risks of vascular injury.
• Careful consideration of material placement and potential for friction is necessary.
• This case highlights a rare but severe complication associated with bioabsorbable tissue reinforcement in thoracic surgery.