Safety of a Novel Microwave Surgical Instrument for Lung Parenchyma Dissection During Segmentectomy

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Surgical Technology

Background:

• The optimal method for dissecting lung parenchyma during lung segmentectomy is debated, with electrocautery and automatic suturing instruments being common choices.
• A novel microwave surgical instrument (MSI) was developed to potentially improve sealing effects during lung parenchyma dissection.

Purpose of the Study:

• To evaluate the feasibility and safety of using a MSI for lung parenchymal dissection in lung segmentectomy.
• To compare the perioperative outcomes of MSI use against traditional automatic suturing instruments.

Main Methods:

• A prospective clinical study involving lung segmentectomy using MSI for intersegmental plane dissection.
• Comparison of perioperative outcomes and sealing-related complications between the MSI group and a control group using automatic suturing instruments.
• Propensity score-matched analysis to mitigate selection bias.

Main Results:

• Successful lung segmentectomy using MSI in 30 patients.
• Significantly lower intraoperative blood loss, shorter hospital stays, and fewer postoperative complications in the MSI group compared to the control group (n=66) after propensity score matching.
• No prolonged air leakage observed; two cases of subcutaneous emphysema post-chest tube removal, with no other grade 2 or higher complications. No 30 or 90-day mortality.

Conclusions:

• Microwave surgical instrument (MSI) use in lung segmentectomy is feasible and safe.
• MSI is associated with reduced intraoperative blood loss, decreased postoperative air leakage, and fewer complications.
• The findings suggest MSI as a promising alternative for lung parenchymal dissection in segmentectomy.