Abstract
Uniportal thoracoscopic major pulmonary resection is used worldwide as a minimally invasive surgery. Occasionally, it is difficult to insert a stapler smoothly during uniportal thoracoscopic major pulmonary resection because of limited angulation. To address this challenge, we used “suction-guided stapling” to divide the bronchus or pulmonary vein. Here, we provide details of this technique, including division of the pulmonary veins or bronchus in a video. In addition, we validate this technique by showing perioperative results of uniportal thoracoscopic major pulmonary resections in our department.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gonzalez D, Paradela M, Gracia J, de la Torre M. Single-port video-assisted thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg. 2011;12:514–6.
Gonzalez-Rivas D, Sihoe ADL. Important technical details during uniportal video-assisted thoracoscopic major resections. Thorac Surg Clin. 2017;27:357–72.
Igai H, Kamiyoshihara M. Uniportal thoracoscopic fissureless right lower lobectomy using the suction device trick. MMCTS. 2019. https://doi.org/10.1510/mmcts.2019.046.
Igai H, Kamiyoshihara M, Kawatani N, Ibe T, Shimizu K. Thoracoscopic caudal left lower lobectomy in a patient with fused fissure. Asian J Endosc Surg. 2014;7:342–4.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None declared.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Supplementary Video description: Case 1 (right upper lobectomy): After division of the first branch of the right pulmonary artery, the right upper bronchus was resected using “suction-guided stapling”. In this technique, the curved suction was inserted between the right upper bronchus and upper lobe. The suction provided space to insert a stapler smoothly and protected the upper lobe from damage caused by misinsertion of the stapler. In addition, the curved body of the suction provided space on the posterior side. Therefore, the tip of the stapler was easily assessed on the monitor. Finally, the right upper bronchus was divided. After division of the right upper bronchus, the upper lobe vein was divided using the same approach. Case 2 (right lower lobectomy): The lower lobe vein and bronchus were divided using the same approach. Case 3 (fissureless left lower lobectomy): This scene outlines stapling of the left lower bronchus after division of the inferior pulmonary vein. It is important to avoid injury to pulmonary arteries behind the bronchus. The inserted suction protects pulmonary arteries from damage caused by misinsertion of the stapler. Arrow shows the tip of the stapler in any case. (MPG 37134 KB)
Rights and permissions
About this article
Cite this article
Igai, H., Furusawa, S., Ohsawa, F. et al. Application of “suction-guided stapling” during uniportal thoracoscopic major lung resection. Gen Thorac Cardiovasc Surg 70, 204–205 (2022). https://doi.org/10.1007/s11748-021-01748-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-021-01748-5