First UK Use of Enseal Tissue Sealer for Pulmonary Right Upper Lobectom

This video demonstrates a three-port video-assisted thoracoscopic right upper lobectomy, performed with the assistance of the Enseal® tissue sealer energy device. This is the first recorded use of the instrument for major pulmonary resection in the United Kingdom. The device is used for tissue dissection, sealing of small vessels (<7mm diameter), and mediastinal lymph node sampling. The Enseal® device was also used to seal the recurrent branch of the pulmonary artery without the requirement for additional clips. Furthermore, the device was used to manage a bleed from a bronchial artery. In this video, the authors demonstrate the safe and effective use of the Enseal® tissue sealer in video-assisted thoracoscopic lung cancer surgery. This device permits: 1. Safe and efficient dissection of soft tissues and pleura; 2. Sealing of pulmonary artery and bronchial vessels; and 3. Clean dissection of mediastinal lymph nodes. The Enseal® device proves cost-effective as it reduces the number of consumable instruments used. It also reduces operative time due to a reduction of instrument changes required. The excised right upper lobe contained two metastatic colorectal carcinomas. References 1. Cattoni M, Rotolo N, Nardecchia E, De Maio S, Dominioni L and Imperatori A. Energy devices safety and impact on video-assisted thoracoscopic lung lobectomy postoperative course: monopolar electrocautery versus ultrasonic dissector. Journal of cardiothoracic surgery. 2021; 16: 40-. 2. Toishi M, Yoshida K, Agatsuma H, et al. Usefulness of vessel-sealing devices for ≤7 mm diameter vessels: a randomized controlled trial for human thoracoscopic lobectomy in primary lung cancer. Interactive cardiovascular and thoracic surgery. 2014; 19: 448-55.