Clinical report on a computer-controlled hand-actuated stapling system for general lung surgery: the first application in Japan

Abstract

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. 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. 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. The new computer-controlled stapling system may be safe and efficient for lung parenchymal tissue resection during open thoracic surgery.