Unveiling the beneficial techniques in lung segmentectomy by using a stapler tractor for vascular dissection based on surgical video replay

The Thoracic Training Course of the Royal College of Surgeons of Edinburgh in China is dedicated to training skilled thoracic surgeons to an elite level. Almost all the learners at the Nanjing training station showed great interest in a novel stapler tractor designed for dissociating segmental vessels during lung segmentectomy. This study aimed to unveil the beneficial of the novel stapler tractor. Three hundred twenty-three patients who underwent lung segmentectomy at the Nanjing training station were retrospectively analyzed. First, surgical outcomes were compared between those who used a stapler tractor for dissociating segmental vessels and those who did not. Secondly, the results of dissociating segmental vessels were compared between the group that used the stapler tractor and the other three techniques. Lastly, the same variable comparisons were made among the learners. Compared with the outcomes of the non-used stapler tractor patient group during the teaching period, the patients in the used stapler tractor group had shorter operation times (143.15 ± 28.05 min vs. 152.83 ± 37.92 min, P = 0.019), less intraoperative bleeding (51.41 ± 42.60 mL vs. 70.70 ± 63.19 mL, P = 0.017), shorter postoperative hospital stays (3.39 ± 0.81 days vs. 3.70 ± 1.07 days, P = 0.008), and a lower incidence of postoperative pulmonary embolism (0.3% vs. 4.2%, P = 0.035). Compared with the results of other techniques for dissociating segmental vessels, the stapler tractor group had a lower occurrence of intraoperative bleeding (P = 0.002), a reduced time for dissociating the vessel (P < 0.05), a greater successful traction ratio (P = 0.022), and a shorter vascular stump length (P = 0.000). The learners reproduced similar outcomes and results in 58 patients across different affiliations. The benefits of using stapler techniques for dissociating vascular structures in lung segmentectomy include, but are not limited to, shortened operation time, reduced intraoperative blood loss, shorter postoperative hospital stays, reduced postoperative air leakage rates, and a lower incidence of postoperative pulmonary embolism, whether during the teaching or learning period.