A novel guiding tube modified from a Foley catheter for endostapling during robot-assisted pulmonary resection

BACKGROUND: Massive intraoperative bleeding resulted from vascular injury during the dissection of pulmonary vessel in minimally invasive lobectomy is a troublesome and dangerous surgical scenario. It is reported that vascular injury result in 29–45% of incidences of conversion to thoracotomy in minimally invasive pulmonary surgery. In this paper, we introduce a guiding tube created from two-way Foley catheter for robotic pulmonary resection in attempting to avoid vascular injury when passing linear stapler. METHODS: From July 2018 to June 2019, this guiding method was adopted in patients who underwent robot-assisted thoracoscopic surgery lobectomy. The technical details and short-term outcomes are described in this paper. RESULTS: A total of 31 patients were successfully treated with robotic pulmonary resection with help of the guiding method presented in this study. The median surgical time was 180 min and the median loss of blood was 100 mL. Only one patient was converted to open thoracotomy for silicoanthracotic lymph nodes adhered in hilum of lung. The median length of hospital stay was 5 days. There was no mortality in 30 days after hospital discharge. CONCLUSIONS: This modified Foley catheter seems to be a promising guiding method to avoid vascular injury when passing linear stapler in robotic pulmonary resection.