Total anatomic vascular dissection for lobectomy by using only energy devices.

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Ultrasonic energy devices revolutionized minimally invasive surgery in the 1990s.
• These devices are now standard in video-assisted thoracoscopic surgery (VATS), particularly for lymph node dissection and transecting pulmonary vessels.
• Advanced application includes hilar anatomic dissection by experienced surgeons.

Purpose of the Study:

• To demonstrate the feasibility and safety of using an ultrasonic energy device for anatomic hilar dissection during uniportal VATS right lower lobectomy.
• To highlight the efficacy of the Harmonic scalpel in performing vascular and bronchial dissection in this context.

Main Methods:

• A right lower lobectomy was performed using uniportal VATS.
• An ultrasonic energy device (Harmonic scalpel) was exclusively used for the anatomic dissection of the artery, vein, and bronchus.
• Surgical time for lobectomy and lymph node dissection was recorded.

Main Results:

• The study video showcases a right lower lobectomy executed via uniportal VATS.
• Anatomical dissection of hilar structures (artery, vein, bronchus) was achieved solely with an ultrasonic energy device.
• The total surgical time for the lobectomy was 30 minutes, with 20 minutes dedicated to lymph node dissection.

Conclusions:

• Energy devices are feasible and safe for vascular and bronchial dissection during lobectomy.
• Successful application requires expertise in thoracoscopic surgery.
• This technique supports efficient and safe minimally invasive thoracic procedures.