Interlobar division using vessel-sealing system in robot-assisted pulmonary lobectomy

Area of Science:

• Thoracic Surgery
• Robotic Surgery
• Surgical Innovation

Background:

• Robot-assisted pulmonary lobectomy is a minimally invasive approach for lung cancer treatment.
• Interlobar fissure division is a critical step in pulmonary lobectomy.
• Current methods may involve robotic staplers, prompting investigation into alternative techniques.

Purpose of the Study:

• To evaluate the safety and efficacy of a novel interlobar fissure division technique using the da Vinci vessel sealing system.
• To compare perioperative and postoperative outcomes of this new technique against traditional robotic stapler use.

Main Methods:

• Retrospective review of 111 patients undergoing robotic pulmonary lobectomy (2018-2020).
• Comparison of outcomes between patients using the da Vinci vessel sealing system and those using robotic staplers.
• Focus on patients with low-grade incomplete fissures (Craig and Walker classification grades 1 and 2).

Main Results:

• The vessel sealing system group demonstrated significantly shorter operative and console times (P=.03, P=.01).
• Reduced median intraoperative blood loss (20 mL vs 50 mL; P=.01) and lower surgical complication rates (2.2% vs 20.0%; P=.01) were observed.
• Lower incidence of persistent air leak (0% vs 10.0%; P=.06) and fewer stapler cartridges used (3.4 vs 5.6; P<.001) favored the vessel sealing system.

Conclusions:

• The da Vinci vessel sealing system is a safe and feasible alternative for interlobar fissure division in robot-assisted pulmonary lobectomy.
• This technique is particularly suitable for patients with low-grade incomplete fissures.
• The findings suggest potential benefits in reduced operative time and complications.