Every day, 78 Canadians receive a diagnosis of lung cancer, the most deadly form of cancer in the country. Some of them will have one of the lobes of a lung remove by thoracotomy, a common, but risky surgical procedure that requires months of recovery. However, a less invasive and safer surgical technique exists and be use more widely.
International clinical study
In a large international clinical study present at the 99th Annual Meeting of the American Association for Thoracic Surgery, Dr. Moishe Liberman, a thoracic surgeon and researcher at the University of Montreal Hospital Research Centre (CRCHUM), and his team show that thoracoscopic lobectomy video assist thoracoscopic surgery (VATS) combine with pulmonary artery sealing using an ultrasonic energy device reduce the risk of post-operative bleeding, complications and pain.
Unlike surgery with thoracotomy, which involves making a 25 cm incision in the patient’s chest and cutting the ribs, a VATS procedure requires small incisions. A miniature video camera is insert through one of the incisions. In both types of surgical interventions, there is a risk of bleeding because the branches; hence of the pulmonary artery are very thin, fragile and are attach directly to the heart.
Thanks to this clinical trial conduct in Canadian, American and British hospitals; so they have show that it is possible to safely seal pulmonary blood vessels through ultrasonic sealing and effectively control possible bleeding during a VATS procedure, explain Dr. Liberman, an Associate Professor of Surgery at the University of Montreal.
Lobectomies around the world
Currently, only 15% of lobectomies around the world are perform by VATS; mainly because of the actual risks of major bleeding or surgeons’ perception of these risks. They truly hope that the results of our clinical trial will reassure surgeons about the technical feasibility; so safety of this operation and will encourage them to adopt it. A large number of patients could benefit from it and be on their feet faster, with less pain,” indicate Dr. Liberman.
After five years of preclinical research at the CRCHUM; so trials conduct on animals; so phase 1 and phase 2 clinical trialsshowing the safety of the surgical intervention, Dr. Liberman’s team has recently complete their large international phase 2 clinical trial launch in 2016. It was able to evaluate the effectiveness of this new technique on 150 patients in eight hospitals across Canada, the United States and the United Kingdom. 139 of them underwent a lobectomy.
A total of 424 pulmonary artery branches were seal during the study: 181 using surgical staplers, 4 with endoscopic clips and 239 using the HARMONIC ACE® +7 Shears, design by the company Ethicon (Johnson & Johnson). With a 3-millimetre jaw at its tip, this high-tech “pistol” allows a surgeon to seal blood vessels by delivering ultrasonic energy. According to the World Health Organization, lung cancer kills nearly 1.69 million people around the world every year.