Safe stapling technique for pulmonary vessels with the shortened introducers and curved tips in thoracoscopic surgery

Endo GIA(™) curved tips with Tri-Stapler(™) is more useful for the approach for pulmonary vessels than conventional straight staplers. Unless adequate space is maintained below the vessels, there is a risk of causing damage to the back of vessels with the curved tip without optional introducers. The recommended method involves passing silk thread through the back of the pulmonary vessels and ligating the thread to the introducer. However, the long introducer often applies tension to pulmonary vessels and can be caught in the tissues surrounding vessels. Therefore, we devised a new method. First, the introducer is shortened to a length of approximately 3 cm and attached to a curved tip. Second, a Penrose drain is passed through the back of the vessels. Last, the introducer is inserted into the drain and the stapler is guided. The vessels can be cut without removing the introducers and Penrose drains from staplers.