Clinical utility of a small diameter four-row stapler reload for large vessel transection in lung transplants

In lung transplantation, there are multiple factors that can contribute to the need for a left atrial cuff reconstruction. While donor and recipient anatomy are inherent considerations during the procedure, other factors like type of surgical devices used may be controlled. This case series describes the safety, ergonomics, and potential left atrial length gain when using a small profile reload during lung transplant recipient pneumonectomies. A single operating surgeon at a single institution performed 35 bilateral lung transplants with a small four-row vascular stapler. 138 firings (136 pulmonary veins and two firings on pulmonary arteries) were analyzed. Twenty-three patients were males (65.7%), mean age was 59.6 ± 12.6 years, and mean BMI was 25.7 ± 4.3 kg/m2. Idiopathic pulmonary fibrosis was the diagnosis in 57% of patients and chronic obstructive lung disease in 29% of the patients. Mean operative time was 7.5 ± 2.04 h. There were no device-related complications. These findings suggest the clinical applicability of a small diameter four-row stapler in recipient pneumonectomies.