Total anatomic vascular dissection for lobectomy by using only energy devices
Original Article on Thoracic Surgery

Total anatomic vascular dissection for lobectomy by using only energy devices

Diego Gonzalez-Rivas1,2

1Minimally Invasive Thoracic Surgery Unit (UCTMI), San Rafael Hospital, Coruña, Spain; 2Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain

Correspondence to: Diego Gonzalez-Rivas, MD, FECTS. Department of Thoracic Surgery, Coruña University Hospita, Xubias 84, 15006, Coruña, Spain. Email: diego.gonzalez.rivas@sergas.es.

Background: The introduction of ultrasonic energy into surgical dissecting devices was a technological breakthrough in minimally invasive surgery in the 1990s.

Methods: Nowadays, the energy devices are used very often during video-assisted thoracoscopic surgery (VATS) especially for lymph node dissection and for transection of small pulmonary vessels. However these devices can be used for hilar anatomic dissection in expert hands.

Results: In this video we show a right lower lobectomy performed by uniportal VATS in where the anatomic dissection of artery, vein and bronchus was performed by only using an ultrasonic energy device (Harmonic scalpel). The total surgical time for lobectomy was 30 minutes and 20 minutes for lymph node dissection.

Conclusions: The use of energy devices for vascular and bronchial dissection during lobectomy is feasible and safe when performed by expert thoracoscopic surgeons.

Keywords: Energy devices; anatomic dissection; lobectomy; uniportal video-assisted thoracoscopic surgery (VATS); vascular dissection


Received: 30 June 2015; Accepted: 01 July 2015; Published: 15 July 2015.

doi: 10.3978/j.issn.2221-2965.2015.07.02


The introduction of ultrasonic energy into surgical dissecting devices was a technological breakthrough in minimally invasive surgery in the 1990s. Nowadays, the modern ultrasonic coagulation shears are used very often during video-assisted thoracoscopic surgery (VATS). The most frequent use is for the lymph node dissection but these devices can be used even for vascular dissection. Some authors recommend avoiding the use of ultrasound energy near vascular structures to prevent thermal injuries from ultrasonic coagulation shears. However, energy devices are very safe in expert hands and the vascular dissection can be performed safely. These devices offer cutting, coagulation, dissecting, and grasping all in a single system. The versatility and safety profiles make ultrasonic energy a compelling technology to consider for VATS lobectomy.

In this video we show an uniportal VATS right lower lobectomy in where the total anatomic hilar dissection was performed by using only ultrasound energy devices (Figure 1).

Figure 1 Total anatomic vascular dissection for lobectomy by using only ultrasound coagulation shears (1). Available online: http://www.asvide.com/articles/603

Acknowledgements

None.


Footnote

Conflicts of Interest: The author has no conflicts of interest to declare.

Informed Consent: Written informed consent was obtained from the patient. A copy of the written consent is available for review by the Editor-in-Chief of this journal.


References

  1. Gonzalez-Rivas D. Total anatomic vascular dissection for lobectomy by using only ultrasound coagulation shears. Asvide 2015;2:060. Available online: http://www.asvide.com/articles/603
doi: 10.3978/j.issn.2221-2965.2015.07.02
Cite this article as: Gonzalez-Rivas D. Total anatomic vascular dissection for lobectomy by using only energy devices. J Vis Surg 2015;1:8.

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