New Instruments for Thoracic Surgery

¹ Moscow, U.S.S.R.

The search for new designs of appliances providing the least traumatization during surgical intervention on the lung has continued. The task of designing an appliance for mechanical suture (with tantalum staples) of the lung tissue in marginal and wedge-shaped resections with two-row buried suture has been under study. The expediency of designing such an appliance is considerable. It would permit one to carry out economic resections of the lung both in injury and disease. The number of pneumonectomies and lobectomies resulting in invalidity would decrease. Besides, such an appliance would place the best (double row buried) suture, which almost excludes development of bronchial fistulae and would provide complete pleurization of the suture line.

After extensive investigations we (P. I. Androsov and A. A. Strekopytov) have succeeded in constructing such an appliance.

The design of this appliance is very simple and permits one to disassemble, assemble and load it easily. Any surgeon will find no difficulty in operating this instrument. It may also be used in abdominal surgery for suturing the stomach stump in its resection for cancer and peptic ulcer, and for suturing the ends of intestines in their resection. A total of 85 operations were performed. In all of the cases the suture placed by the appliance proved to be hermetic with correct approximation of the margins of the stomach and intestinal wall, and exhibited reliable hemostasis. In addition, during the operation there was a lesser degree of traumatization of the stomach and intestinal walls and pulmonary tissue. Operations were aseptic and less time consuming. The postoperative course was smooth in all the patients.

In general, appliances for thoracic operations have found very wide application in our country. Data, which are far from complete, indicate that by means of suturing apparatus surgeons have already performed over 7,000 extensive surgical operations on the lungs, heart, and blood vessels. From the published data it can be concluded that the general mortality rate in pulmonary operations ranged from 10 to 14 per cent. With the use of the YKB and YKL appliances the mortality rate has decreased to 3.5 per cent. In individual cases these appliances have made it possible to operate on patients with such infections of the lungs which were regarded as inoperable by the usual manual method of the pulmonary hilar treatment.