Thorac Cardiovasc Surg 2017; 65(01): 065-069
DOI: 10.1055/s-0036-1586722
Short Communication
Georg Thieme Verlag KG Stuttgart · New York

Ultrasonic Technology for Management of Primary Spontaneous Pneumothorax

Alfonso Fiorelli
1   Thoracic Surgery Unit, Seconda Università degli Studi di Napoli, Naples, Italy
,
Antonio Mazzella
1   Thoracic Surgery Unit, Seconda Università degli Studi di Napoli, Naples, Italy
,
Marina Accardo
2   Anatomic Pathology Unit, Seconda Università degli Studi di Napoli, Naples, Italy
,
Mario Santini
1   Thoracic Surgery Unit, Seconda Università degli Studi di Napoli, Naples, Italy
› Author Affiliations
Further Information

Publication History

03 April 2016

07 July 2016

Publication Date:
12 September 2016 (online)

Abstract

To manage primary spontaneous pneumothorax, we use an alternative technique for bleb resection and we induce pleurodesis with an ultrasonic-driven scalpel. This technique was successfully performed in nine consecutive patients with primary spontaneous pneumothorax with small (<20 mm) and limited number of blebs (<2) and without significant underlying lung disease. After identification of air leakage, the jaws of the instrument were clamped onto the bleb and included a margin of normal lung. Power level 3 energy was applied to resect the bleb and to seal the parenchyma. Finally, the parietal pleura was partially scarified using the same instrument to achieve pleurodesis. Histologic findings showed complete sealing of the resection line by coagulative tissue.

 
  • References

  • 1 MacDuff A, Arnold A, Harvey J ; BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010; 65 (Suppl. 02) ii18-ii31
  • 2 Shigemura N, Akashi A, Nakagiri T, Ohta M, Matsuda H. A new tissue-sealing technique using the Ligasure system for nonanatomical pulmonary resection: preliminary results of sutureless and stapleless thoracoscopic surgery. Ann Thorac Surg 2004; 77 (4) 1415-1418 , discussion 1419
  • 3 Li Z, Chen L, Wang J , et al. A single institution experience using the LigaSure vessel sealing system in video-assisted thoracoscopic surgery for primary spontaneous pneumothorax. J Biomed Res 2014; 28 (6) 494-497
  • 4 Sawabata N, Ikeda M, Matsumura A, Maeda H, Miyoshi S, Matsuda H. New electroablation technique following the first-line stapling method for thoracoscopic treatment of primary spontaneous pneumothorax. Chest 2002; 121 (1) 251-255
  • 5 McKenna Jr RJ, Brenner M, Gelb AF , et al. A randomized, prospective trial of stapled lung reduction versus laser bullectomy for diffuse emphysema. J Thorac Cardiovasc Surg 1996; 111 (2) 317-321 , discussion 322
  • 6 Kovács O, Szántó Z, Krasznai G, Herr G. Comparing bipolar electrothermal device and endostapler in endoscopic lung wedge resection. Interact Cardiovasc Thorac Surg 2009; 9 (1) 11-14
  • 7 Fiorelli A, Accardo M, Carelli E , et al. Harmonic technology versus neodymium-doped yttrium aluminium garnet laser and electrocautery for lung metastasectomy: an experimental study. Interact Cardiovasc Thorac Surg 2016; 23 (1) 47-56
  • 8 Samancilar O, Cakan A, Cetin Y , et al. Comparison of the harmonic scalpel and the ultrasonic surgical aspirator in subsegmental lung resections: an experimental study. Thorac Cardiovasc Surg 2007; 55 (8) 509-511
  • 9 Ambrogi MC, Zirafa CC, Davini F , et al. Transcollation® technique in the thoracoscopic treatment of primary spontaneous pneumothorax. Interact Cardiovasc Thorac Surg 2015; 20 (4) 445-448
  • 10 Bridevaux PO, Tschopp JM, Cardillo G , et al. Short-term safety of thoracoscopic talc pleurodesis for recurrent primary spontaneous pneumothorax: a prospective European multicentre study. Eur Respir J 2011; 38 (4) 770-773
  • 11 Min X, Huang Y, Yang Y , et al. Mechanical pleurodesis does not reduce recurrence of spontaneous pneumothorax: a randomized trial. Ann Thorac Surg 2014; 98 (5) 1790-1796 , discussion 1796