Thursday , August 18 2022

Lung cancer: Less invasive surgery for faster recovery


Every day, 78 Canadians are diagnosed with lung cancer, the most deadly type of cancer in the country. Some of them will have one of the lungs pulled by a thoracotomy, a common surgical procedure, but a risk that requires months of recovery. However, a less intrusive and safer surgical technique exists and could be used more widely.

In a major international clinical study presented in the 99th Annual Meeting of the American Thoracic Surgery Association, Dr Moishe Liberman, thoracic surgeon and researcher at the Montreal University Hospital Research Center (CRCHUM), and his team showed that thoracoscopic lobectomy – video-assisted thoracoscopic surgery (VATS) – to combine with pulmonary artery sealing using an ultrasonic energy device has reduced the risk of bleeding, complications and pain after surgery.

Unlike surgery with thoracotomy, which involves making a 25 cm cut in the patient's chest and cutting the ribs, the VATS procedure requires small cuts. A small video camera is set through one of the cuts. In both types of surgical intervention, there is a risk of bleeding because the pulmonary artery branches are very thin, fragile and have been directly linked to the heart.

"Thanks to this clinical trial carried out at Canada, American and British hospitals, we have shown that it is possible to seal pulmonary blood vessels safely through ultrasonic sealing and effective bleeding control effectively during the VATS procedure," explained Dr. Liberman, Associate Professor of Surgery at Montréal University.

Currently, only 15% of worldwide lobectomas are performed by VATS, mainly due to the real risks of major bleeding or surgeons' perception of these risks.

"I hope that the results of our clinical trial will reassure surgeons about the technical feasibility and safety of this operation and encourage them to adopt them. A large number of patients could benefit from it and they would be quicker. T , with less pain, "said Dr. Liberman.

Next generation device

After five years of clinical research in the CRCHUM, animal trials, stage 1 and stage 2 clinical trials showing the safety of the surgical intervention, Dr.'s team. Liberman has completed their major stage 2 clinical trial launched in 2016 recently.

He 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 had a lobectomy, while the remaining 11 had semementectomy (a small part of the lungs).

A total of 424 pulmonary artery branches were sealed during the study: 181 using surgical staplers, 4 with endoscopic clips and 239 using HARMONIC ACE® +7 Shears, designed by Ethicon (Johnson & Johnson) company. With a 3-millimeter jaw, this high-tech "pistol" allows a surgeon to seal blood vessels by providing ultrasonic energy.
According to the World Health Organization, lung cancer kills almost 1.69 million people worldwide every year.


This study received funding from Johnson & Johnson and from the hospital's Center of Universit de Montréal (CHUM). Identifier: NCT02719717

Further reading: "Preview, Multi-Center, International Stage 2 Trial Evaluation of Ultrasonic Energy for the Sealing of Arteries Branch of the Lung at VATS Lobectomy" by Dr. Moishe Liberman et al. in the Journal of Thoracic and Surgery Surgery

About the CRCHUM

The Montreal University Hospital Research Center (CRCHUM) is one of North America's major research centers. We strive to improve the health of adults through a research continuum covering disciplines such as basic sciences, clinical research and public health. Over 1,861 people work in the CRCHUM, including 542 scientists and 719 students and research assistants.


The Université de Montréal

Having been deeply rooted in Montréal and dedicated to its international mission, Université de Montréal is one of the best universities in the French world. Established in 1878, Université de Montréal, consists of 16 faculties and schools today, and together with two affiliated schools, HEC Montréal and Polytechnique Montréal, is the largest center for higher education and research in Québec and one of; the main centers in North America. It brings together 2,500 teachers and researchers and welcomes more than 60,000 students.

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