Energized lung resections

Abstract

In this edition of the Journal, Okada and colleagues 1 report on a prospective feasibility study evaluating vascular energy sealing using the LigaSure Device (Medtronic, Louisville, Colo) in anatomic lung resection. The LigaSure Device is an advanced bipolar energy device. The study was designed to evaluate sealing in vessels up to and including 7 mm in diameter (both pulmonary arteries and veins) in 328 patients. This is the largest prospective trial to date evaluating the safety and feasibility of vascular energy sealing in anatomic lung resections. The single cohort trial was stopped and then changed after 128 patients were recruited because of a postoperative hemorrhage. The trial was reopened after the design was changed to a 2-cohort design. In the amended study, veins up to 7 mm in diameter and arteries up to 5 mm in diameter were sealed using the energy device. Data such as these are extremely important before widespread application of the device in clinical practice. Energy application for pulmonary vessel control and ligation is extremely attractive because of the low profile of the device tip, the thin shaft of the instrument, and the ability of the energy device to be used for hilar dissection and lymph node dissection (Figure 1). Although multiple