Clinical report on a computer-controlled hand-actuated stapling system for general lung surgery: the first application in Japan.
OBJECTIVE
Computer-controlled stapling systems can improve lung tissue approximation during thoracic surgery. We report our experience with a handy system with computer-controlled placement of staples for lung resection in Japan.


METHODS
The iDrive system is the improved second version of the SurgAssist stapling system. It comprises a self-contained computer microprocessor and hand-held control unit combined with a digital loading unit (a power linear cutter with a blue or green cartridge) for use in open and minimally invasive thoracic surgery. The mounted control unit has two uses: (1) controlling accurate placement of the cartridge by orientating the tip of the rigid and curved shaft and (2) controlling the closure of the stapler and the firing. Each cartridge contains a programmed electronic device that triggers activation of the appropriate program in the self-contained microprocessor. The compression level on lung tissue is determined by the computer.


RESULTS
From March to October 2008, the iDrive system was used 53 times in a consecutive series of 39 patients during open thoracic lung surgery. There were 12 women and 27 men. The following procedures were performed: lobectomy, segmentectomy, and wedge resection. The power linear cutters were used for stapling lung parenchyma for wedge resection in 6 patients, bullectomy in 1, segmentectomy in 2, and fissure division in 33. There were no stapling failures and no complications related to the staplers.


CONCLUSIONS
The new computer-controlled stapling system may be safe and efficient for lung parenchymal tissue resection during open thoracic surgery.
Department of Thoracic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara-shi, Kanagawa, 228-8555, Japan. ysatoh@med.kitasato-u.ac.jp
Yukitoshi
Y
Satoh
Yoshio
Y
Matsui
Fumihiro
F
Ogawa
Hideki
H
Amano
Hidenori
H
Hara
Kenji
K
Nezu
Akira
A
Iyoda
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation*; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000009:adverse effects / Q000295:instrumentation*; D013908:Thoracotomy / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome