New Method for Pulmonary Artery Sealing During VATS Shows Promise

A new method of pulmonary artery branch sealing, using ultrasonic energy during video-assisted thoracoscopic surgery (VATS), successfully seals arteries measuring 7 mm in diameter or less, according to new research.

The results of the research were presented by lead author Moishe Liberman, MD, PhD, at the American Association for Thoracic Surgery (AATS) 99th Annual Meeting.

To conduct their study, Dr Liberman and colleagues enrolled 150 patients who were scheduled for VATS or robotic anatomical lung resection in 7 centers in the United States, Canada, and the United Kingdom.

During the surgery, the diameters of all pulmonary arteries were measured; those measuring 7 mm or less were sealed and divided with an ultrasonic energy vessel-sealing device called the HARMONIC ACE+7.

The researchers also tracked patients’ intraoperative, in-hospital, and 30-day post-surgery outcomes and complications.

After analyzing the data, Dr Liberman and colleagues found that the mean pulmonary artery diameters were 4.7 mm for the ultrasonic vessel-sealing device, 10.3 mm for endostaplers, and 6.5 mm for endoscopic clips.

Of the 239 pulmonary artery branches that were divided with the ultrasonic vessel-sealing device, 3 bled intraoperatively; 4 of the 181 pulmonary arteries divided with endostaplers had bled intraoperatively. However, no post-operative bleeding or 30-day mortality was noted.

“[Pulmonary artery] branch sealing with ultrasonic energy during VATS lobectomy is safe for vessels of 7mm or less,” the researchers concluded. “With appropriate training, the use of an ultrasonic vessel-sealing device is a reasonable alternative for vascular sealing in [pulmonary artery] branches of 7mm or less.”

—Amanda Balbi

Reference:

Liberman M, Goudie E, Morse C, et al. Prospective, multi-center, international phase 2 trial evaluating ultrasonic energy for pulmonary artery branch sealing in VATS lobectomy. Presented at: American Association for Thoracic Surgery (AATS) Annual Meeting; May 4-7, 2019; Toronto, Canada. https://www.aats.org/aatsimis/AATSWeb/Association/Meetings/Annual_Meeting/99th_Annual_Meeting/AATS_99th_Annual_Meeting_Abstracts/2019-A-655-AATS-44.aspx. Accessed May 7, 2019.