Robotic-Assisted Lower Lobectomy With Bronchoplasty Using Barbed Suture

Endobronchial carcinoid tumors require bronchoplasty, which can control the resection margins and subsequent postobstruction secretions and potential infection focus. For the classical open thoracotomy cases, bronchoplasty is performed with classical direct straightforward surgical knotting of interrupted sutures. However, in the era of minimally invasive surgery, this technique can be time consuming, which makes intra or extracorporeal knotting troublesome. 

The introduction of looped barbed suture technology allows for continuous suturing and requires only one surgical (robotic assisted or video assisted) knot. In this video, surgeons performed the closure of the lower lobe bronchus using two sutures, one cranial to caudal direction and the second from caudal to cranial direction, using one knot at the midpoint. A pleural patch plasty followed, with another knot that showed a negative water test and a rash postoperative chest tube removal to end the procedure.

References

1. Sarsam OM, Dunning J, Pochulu B, Baste JM. Robot-assisted bronchoplasty using continuous barbed sutures. J Vis Surg. 2018 Jan 4:4:3. doi: 10.21037/jovs.2017.12.14. eCollection 2018. PMID: 29445589
2. Nakagawa T, Chiba N, Ueda Y, Saito M, Sakaguchi Y, Ishikawa S. Gen Thorac Cardiovasc Surg. 2015 Nov;63(11):640-3. doi: 10.1007/s11748-014-0517-4. Epub 2015 Jan 8. PMID: 25566984

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