Experimental study in pulmonary artery sealing with a vessel-sealing device.
BACKGROUND
The development of vessel-sealing devices will facilitate safety in video-assisted thoracoscopic surgery. Our objective was to evaluate the feasibility and safety of sealing pulmonary arteries with the Enseal tissue-sealing device.


METHODS
Pulmonary arteries from beagle dogs (mean body weight 13.1 kg, range 10.5-15.4 kg) were divided into 3 groups according to the in-vivo sealing method used (Enseal, ligation, and proximal ligation plus distal Enseal) and extracted to evaluate the pressure tolerance up to 75 mm Hg at the sealed end. A left lower lobectomy was performed to evaluate chronic-phase durability of the sealed stumps in a survival model. Two or three branches of the pulmonary arteries in each dog were allocated to each of the 3 groups. After the scheduled survival period, the pulmonary arteries were sampled.


RESULTS
Pressure tolerance at the sealed end was evaluated in 91 pulmonary artery sections. All sealed ends showed pressure tolerance >75 mm Hg. A left lower lobectomy was performed in 13 dogs in which 35 pulmonary artery sections had been allocated into the 3 groups. No sealing failure was found, and pathological findings showed healing and persistent hemostasis at all sealed ends of the pulmonary arteries after 2 and 4 weeks of the survival period.


CONCLUSIONS
Pulmonary arteries sealed in vivo with the Enseal device showed pressure tolerance >75 mm Hg in the acute phase, and persistent hemostasis after 2 or 4 weeks. Pulmonary artery sealing with the Enseal device is feasible and safe in thoracic surgery settings.
Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Tetsu
T
Yamada
Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Terumasa
T
Sowa
Department of Thoracic Surgery, St. Luke's International Hospital, Tokyo, Japan.
Toru
T
Bando
Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan hdate@kuhp.kyoto-u.ac.jp.
Hiroshi
H
Date
D000818:Animals; D062186:Arterial Pressure; D004285:Dogs; D004867:Equipment Design; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006489:Hemostatic Techniques / Q000295:instrumentation*; D008026:Ligation; D023421:Models, Animal; D011013:Pneumonectomy / Q000009:adverse effects*; D011651:Pulmonary Artery / Q000503:physiopathology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*
Hemostatic techniques; Models; Nanotechnology; Pulmonary artery; Thoracic surgery; animal; lobectomy; video-assisted