Video-assisted thoracoscopic surgery less invasive, makes recovery faster

A research has shown that thoracoscopic lobectomy- video-assisted thoracoscopic surgery (VATS) - together with pulmonary artery sealing using an ultrasonic energy device decreased the risk of post-operative bleeding, complications and pain.

The study was published in the Journal of Thoracic and Cardiovascular Surgery.

"I truly hope that the results of our clinical trial will reassure surgeons about the technical feasibility and safety of this operation and will encourage them to adopt it. A large number of patients could benefit from it and would be on their feet faster, with less pain," said Dr Moishe Liberman, one of the researchers.

Unlike surgery with thoracotomy, which involves making a 25 cm incision in the patient's chest and cutting the ribs, a VATS procedure requires small incisions.

 

A miniature video camera is inserted through one of the incisions. In both types of surgical interventions, there is a risk of bleeding because the branches of the pulmonary artery are very thin, fragile and are attached directly to the heart.

"Thanks to this clinical trial conducted in Canadian, American and British hospitals, we have shown that it is possible to safely seal pulmonary blood vessels through ultrasonic sealing and effectively control possible bleeding during a VATS procedure," explained Dr Liberman.

Currently, only 15 per cent of lobectomies around the world are performed by VATS, mainly because of the actual risks of major bleeding or surgeons' perception of these risks.

Dr Liberman's team has recently completed its large international clinical trial launched in 2016.

The study was able to evaluate the effectiveness of this new technique on 150 patients in eight hospitals across Canada, the United States and the United Kingdom. 139 of them underwent a lobectomy, while the remaining 11 underwent a segmentectomy (removal of a small part of the lung).

A total of 424 pulmonary artery branches were sealed during the study: 181 using surgical staplers, four with endoscopic clips and 239 using the HARMONIC ACE(r) +7 Shears, designed by the company Ethicon. With a 3-millimetre jaw at its tip, this high-tech "pistol" allows a surgeon to seal blood vessels by delivering ultrasonic energy. According to the World Health Organization, lung cancer kills nearly 1.69 million people around the world every year.