Use of a novel vessel-sealing device for peripheral lung biopsy and lung lobectomy in a cadaveric model.

Abstract

To evaluate the Caiman vessel-sealing device for peripheral lung biopsy and total lung lobectomy in cadaveric canine lung lobes. Twelve lung lobes were randomly assigned to peripheral lung biopsy (n=6) or total lung lobectomy (n=6) with the 12-mm Caiman vessel-sealing device. Lungs were connected to a ventilator set at 10 breaths per minute with an initial pressure of 5cm H2 O during the procedure. The lungs were submerged in water for leak testing and the pressure increased until leakage occurred. Mean airway pressure at which leakage occurred was 39.17 ±13.20 cm H2 O for peripheral lung biopsies and 38.33 ±13.67 cm H2 O for total lung lobectomies. None of the samples leaked below 25 cm H2 O, which is well above the physiologic airway pressure. Histologically, the largest bronchial diameter at the sealed area was 8.84 mm and the extent of collateral damage was approximately 2.7mm in all specimens. The Caiman vessel-sealing device was successfully used for peripheral lung biopsy and total lung lobectomy in cadaveric canine lung lobes. All sealed lung lobes tolerated supra-physiologic airway pressure, displayed minimal collateral damage, and were of good diagnostic quality. Further experimental studies are needed to evaluate the clinical safety of the device for peripheral lung biopsy or total lung lobectomy.