The Radial Stapler Facilitates Lung-Conserving Wedge Resections. Issue 5 (September 2020)

• Record Type: Journal Article
• Authors: Makey, Ian A.; El-Sayed Ahmed, Magdy M.; Jacob, Samuel
• Is Part Of: Innovations. Volume 15:Issue 5(2020)
• Page Start: 463
• Page End: 467
• Publication Date: 2020-09
• Subjects: surgical margins -- radial stapler -- wedge resection -- lung metastasectomy -- lung conserving; Cardiovascular system -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Thorax -- Chirurgie -- Méthodologie -- Périodiques; Vaisseaux sanguins -- Chirurgie -- Méthodologie -- Périodiques; Blood-vessels -- Surgery; Chest -- Surgery; Periodicals; 617.41
• DOI: 10.1177/1556984520942370
• Languages: English
• ISSNs: 1556-9845

Abstract

Objective: To test whether use of the radial stapler facilitates lung-conserving wedge resections compared to the linear stapler. Methods: A video-assisted thoracoscopic simulation lab was established to compare wedge resections performed only with linear staplers to wedge resections performed with the option of a radial stapler. Preserved sheep lungs were used. The target was a 0.5 cm mark on an ovoid surface of the lung equidistant from all edges. Seven fully trained cardiothoracic surgeons participated. They were instructed to obtain at least a 1 cm margin in all directions from the mark. The surgeons were allowed to work from only 2 preassigned ports. Each resected specimen was weighed. The resection margin was the shortest distance measured from the edge of the mark to the staple line. The mass-to-margin ratio was defined as the mass of the specimen divided by the length of the margin. The results were analyzed using a t -test for 2 independent means. Results: The 17 radial resections demonstrated a significantly better mass-to-margin ratio (3.31 [SD = 1.19]) compared to the 11 linear resections (4.75 [SD = 1.32], t [26] = 3, P = 0.006). Conclusions: In a thoracoscopic simulation, the option of a radial stapler allowed for a better mass-to-margin resection of a small target from a broad surface of the lung than a linear stapler-only option.