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Surgery Today

01-05-2024 | Lung Cancer | Original Article

Maximum resistance pressure at the time of lung tissue rupture after porcine lung transection using automatic linear staplers with different reinforcement methods

Authors: Shinkichi Takamori, Tomoyoshi Takenaka, Mototsugu Shimokawa, Asato Hashinokuchi, Kyoto Matsudo, Taichi Nagano, Mikihiro Kohno, Naoko Miura, Tomoharu Yoshizumi

Published in: Surgery Today

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Abstract

Purposes

Polyglycolic acid (PGA) sheets, fibrin glue, and staple line reinforcement are frequently used to prevent air leakage during lung resection. However, the optimal staple-line reinforcement method remains unclear.

Methods

Cranial lung lobes of pigs were used to evaluate different staple line reinforcement methods (n = 6). Ventilator-assisted manometry was used to measure the maximum resistance pressure at the time of rupture of the lung tissue after stapling.

Results

The mean maximum resistance pressures at the time of lung tissue rupture after using the stapler alone, stapler with PGA sheet and fibrin glue, and stapler with reinforcement were 38.0 cmH2O, 51.3 cmH2O, and 62.7 cmH2O, respectively. A significant increase in the maximum resistance pressure was observed with stapler reinforcement (P < 0.001), while the differences between the other groups were not statistically significant (P = 0.055, P = 0.111). A histological assessment revealed disruption of alveolar structures near the needle-stitching site in the stapler alone, and in the stapler with PGA sheet and fibrin glue groups. Pleural rupture near the staple line was observed in the stapler with reinforcement group.

Conclusions

The maximum resistance pressure before air leakage was significantly higher when using a stapler with reinforcement than when using a stapler alone.
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Metadata
Title
Maximum resistance pressure at the time of lung tissue rupture after porcine lung transection using automatic linear staplers with different reinforcement methods
Authors
Shinkichi Takamori
Tomoyoshi Takenaka
Mototsugu Shimokawa
Asato Hashinokuchi
Kyoto Matsudo
Taichi Nagano
Mikihiro Kohno
Naoko Miura
Tomoharu Yoshizumi
Publication date
01-05-2024
Publisher
Springer Nature Singapore
Published in
Surgery Today
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-024-02858-2