Adverse Events of Lung Tissue Stapling in Thoracic Surgery

The advantages of selecting cartridges with a 1.8 mm height for pulmonary stapling

“…However, the selection of the appropriate cartridge, particularly the choice between green or gold and blue or gold, is sometimes confusing. The results of the present study may encourage surgeons to select the gold cartridges Previous case reports and small-sized studies have reported the complications associated with pulmonary stapling [9,10], and we also previously reported staplingrelated complications using a large number of cases performed with various staplers [8]. However, due to the usage of various staplers, the analysis for complications was unclear and it was not possible to determine the most appropriate stapler for this procedure.…”

“…In general, complications of intraoperative stapling include stapling failure, laceration, oozing, air leakage, technical injury of the tissue, and rupture of the stamp as reported elsewhere [8]. Stapling failure was defined as incomplete stapling with incomplete fastening of staples due to any cause, such as a stapler defect and the inappropriate usage of staplers.…”

“…However, the choice of stapler cartridges for this procedure is not easy since the risk of complications associated with stapling and the individual staplers is not clear. We previously analyzed the complications and adverse events associated with the stapling of the pulmonary parenchyma, but we could not determine the most appropriate cartridges for this procedure from that study [8].…”

Efficacy of the Segment-Counting Method in Predicting Lung Function and Volume Following Stapler-Based Thoracoscopic Segmentectomy

“…5) In contrast, it has also been determined that when lung parenchyma is separated with staples, postoperative atelectasis and peri-staple hematomas may occur. 6,7) Further, the tucking up of parenchymal tissue with sturdy staples may lead to insufficient postoperative lung expansion, 8,9) which may interfere with the postoperative recovery of pulmonary function and volume. However, there is limited evidence regarding the postoperative LF and volume following thoracoscopic surgery by using staplers, as opposed to open surgery.…”

That's one small step…

“…The safety of using ultrasonic energy to seal pulmonary arteries in no way can be compared with the safety of vascular staplers, the failure rate of which has been estimated to be 0.1% to 0.3%. 2,3 Although there were no sealing failures or bleeding complications resulting from the 14 vessels sealed in these 10 patients, a study with at least 2 orders of magnitude more vessels divided (1003) would need to be performed to provide evidence that ultrasonic energy sealing of pulmonary vessels is ''safe,'' if we define ''safe'' as having a failure rate equal to or less than our existing technology.…”