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Background: The Thoraguard Surgical Drainage System is a novel device for drainage of air and fluid after cardiothoracic surgery.Methods: A three-part study was conducted: a prospective observational safety and feasibility study, a retrospective comparison of patients managed with an analogue drainage system, and a clinician userfeedback survey.Results: Fifty patients underwent robotic pulmonary resection utilizing the Thoraguard system for postoperative drainage. The Thoraguard system detected a higher number of air leaks than an analogue system (36/50, 72% vs. 45/200, 23%; P<0.001) and was associated with decreased chest tube duration of 1 day [interquartile range (IQR) 0-2] vs. 2 days (IQR 2-3) (P=0.042) and hospital length of stay of 2 days (IQR 2-3) vs. 3 days (IQR 2-4) (P=0.027). Patients with a peak air leak less than 100 mL/min (32 patients, 64%), had a decreased median chest tube duration of 1 day (IQR 0-1) vs. 2.8 days (IQR 1-3) (P=0.004). Compared to an analogue system, the Thoraguard system had superior user-reported ability to detect air-leaks (17/23, 74%), better ease of patient ambulation (14/23, 61%), and better display of clinically relevant information (22/23, 96%). Conclusions:The Thoraguard Surgical Drainage System provides safe and effective drainage post pulmonary resection. Compared to an analogue system, the Thoraguard system detected a higher number of air leaks and was associated with decreased chest tube duration and hospital length of stay. User survey data reported superior air leak detection, display of clinical data, and ease of use of the Thoraguard system.

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