Stapleless thoracoscopic lobectomy for congenital pulmonary airway malformation: a simple technique in thoracoscopic surgery

J Surg Case Rep. 2023 May 15;2023(5):rjad247. doi: 10.1093/jscr/rjad247. eCollection 2023 May.

Abstract

Congenital pulmonary airway malformation (CPAM) is a developmental malformation that affects the lung parenchyma, especially terminal respiratory bronchioles. This paper reports a case of an infant diagnosed with CPAM who underwent stapleless thoracoscopic lobectomy using Hem-o-Lok clips®. Computed tomography showed cystic pulmonary lesions in the left lower lobe. Thoracoscopic lobectomy was performed at the age of 1 year and 3 months. During surgery, the hilar vasculature was treated using either Hem-o-Lok® clips or a LigaSure vessel sealing system. The lower lobe bronchus was divided using double Hem-o-Lok® clips proximally. The surgery was successfully completed. The patient's postoperative course was uneventful, and there were no complications. This technique can be easily performed as a thoracoscopic lobectomy with the potential benefits of safe and effective procedures for bronchus closure and vascular sealing in the small working space of pediatric patients.

Keywords: Congenital pulmonary airway malformation; Hem-o-Lok; Pediatrics; Thoracoscopic lobectomy.