Single-port thoracoscopic wedge resection using the Endo GIA Radial Reload: outcome of 15 cases

We previously described the technique for single-port thoracoscopic lung wedge resection using the Endo GIA^TM Radial Reload surgical stapler. The GIA Radial Reload has a curved cut line that is perpendicular to the direction of instrument insertion, facilitating the approach to the lung tissue behind the lesion. Herein, we report the outcomes of 15 cases using this procedure.

Between August 2016 and February 2018, 15 patients underwent single-port thoracoscopic wedge resection using the Endo GIA Radial Reload. Single-port thoracoscopic surgery was performed through 3-5-cm incisions. For the first stapler, we used a GIA Radial Reload cartridge. For the second and subsequent staplers, we used the GIA Radial Reload cartridge or a straight cartridge based on the direction of the cut.

In one patient, we extended the incision up to 7 cm and performed video-assisted thoracotomy because the lesion was too small to find. In the other 14 patients, the procedure was completed through a 3-5-cm port. In one patient, we added a suture for air leakage detected intraoperatively. Postoperative air leakage occurred in two patients. These three patients had emphysema based on computed tomography. In the remaining 12 patients, no air leakage was found and the chest tube was removed on postoperative day 1.

This procedure is suitable for resecting small nodules, because palpation with two fingers is easy. The GIA Radial Reload cartridge may not be a good choice for emphysematous lung, because air leakage sometimes occurs.