Obturation par système de ligature thermo-fusion de l'artère pulmonaire dans les lobectomies par vidéothoracoscopie. "From Bench to Bedside".

 

Moishe Liberman

Centre de recherche du CHUM

 

Domaine : cancer

Programme chercheurs-boursiers cliniciens - Junior 2

Concours 2014-2015

Lobectomy is the primary treatment strategy for operable early stage lung cancer. Video Assisted Thoracoscopic Surgery (VATS) anatomical lung resection (lobectomy) provides an effective minimally invasive treatment strategy for stage I and II lung cancer. VATS lobectomy is associated with significantly less postoperative complications, decreased length of stay, earlier return to pre-operative baseline and increased tolerance for adjuvant chemotherapy compared to lobectomy using standard chest incisions (thoracotomy).

Although VATS lobectomy has been proven to be effective, it is not devoid of complications. These complications, when related to major bleeding from pulmonary arterial (PA) branches, can be catastrophic. Currently, a minority of anatomical pulmonary resections are being performed by VATS. We believe that if we can decrease the manipulation on the PA branches, we can make these procedures safe and therefore more commonly utilized for lung resection.

VATS lobectomy is currently being performed using endoscopic staplers for PA branch ligation and separation. Advanced bipolar and ultrasonic devices utilise bipolar electrical current, tissue opposition and compression to achieve better tissue sealing. These devices can be used to seal vessels. These devices are used in the abdomen for vessel sealing (systemic arteries), however, have not been tested for PA sealing.

The proposed comprehensive research program will consist of a series of 4 studies. These studies will evaluate and test the safety of these devices in animal and human models in the performance of VATS lobectomy. We believe that if we can decrease the manipulation required by the surgeon on the PA branches, we can make these procedures safer, less stressful for the pulmonary surgeon and therefore more common for anatomical pulmonary resections.