Techniques for dividing incomplete pulmonary interlobar fissure using bipolar soft coagulation forceps in...

This study aimed to evaluate the electrical characteristics of the da Vinci system's bipolar soft coagulation mode and to assess its feasibility for dividing incomplete pulmonary interlobar fissures during robot-assisted thoracoscopic surgery. The electrical properties of the bipolar soft coagulation mode were analyzed using an electrocautery analyzer. Additionally, safety was assessed through experiments on animal tissue with an infrared thermographic camera. Finally, a retrospective review of clinical cases was conducted to evaluate the use of bipolar soft coagulation forceps for dividing incomplete interlobar fissures in robot-assisted thoracoscopic surgery. Resistance-voltage curves exhibited a plateau phase across all settings, ranging approximately from 53 to 120 V. No carbonization was observed in animal tissue at temperatures below 100 °C. In 23 robot-assisted lung resections using bipolar soft coagulation forceps, the average number of stapler cartridges required for interlobar division was significantly lower compared to the stapler group. Perioperative outcomes were comparable between the two groups. Bipolar soft coagulation forceps are a feasible and safe alternative for dividing incomplete pulmonary interlobar fissures in robot-assisted thoracoscopic surgery, with the added benefit of reducing stapler usage.