Author of

• 10643

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  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10651

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    P1.07-008 - The application of SOFT COAG in combination with Triangle-Tensioning for VATS lobectomy and segmentectomy (ID 903)

    09:30 - 09:30  |  Author(s): Y. Nakayama
    • Abstract

    Background
    This article describes the application of SOFT COAG electrosurgical output mode of VIO (ERBE Elektromedizin GmbH, Tubingen, Germany) in combination with triangle-tensioning (HIMEJI method, Yamamoto et al, 2010, Annals of Thoracic Surgery). The method is to expand the operative field in 3 directions, centering the targeted area. With the combination 2 advantages are considered; operative ease by the method and additional safety by SOFT COAG that generates no electric sparks for unintended tissue damage.

    Methods
    By the method each apex is tensioned in radial fashion towards 3 directions, making effective operative field. For resection of pulmonary artery A2 in upper lobectomy, the artery is pulled to its original direction with the lung fully stretched. The principal surgeon and his assistant oppositely stretch the tissue around the artery in parallel directions to the longitudinal axis of the artery. Connected with SOFT COAG, the endoscopic scissors are applied slightly open, to capture, coagulate, and dissect the capsule. Including the bronchial artery, the method can be used to treat other arteries in VATS lobectomy. One of the fine applications is to treat thin pulmonary arteries with ERBE’s BiClamp® forceps which enables ligation and clip-less procedure.

    Results
    In consecutive anatomical resections of 58 cases: 49 lobectomies (right upper: 18, right middle: 4, right lower: 12, left upper: 6, left lower: 9) including 20 mediastinum lymph nodes dissection: 9 segmentectomies are included. Blood-loss and mean operation time are: 257 minutes and 130ml with mediastinum lymph nodes dissection and 223 minutes and 86ml without. All cases went safe with no severe complications.

    Conclusion
    The triangle-tensioning method in VATS resection is rational and practical. In addition, the combination with SOFT COAG enables safe and simple dissection.