Thorac cardiovasc Surg
DOI: 10.1055/s-0037-1606313
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Use of a Powered Stapling System for Minimally Invasive Lung Volume Reduction Surgery: Results of a Prospective Double-Blind Single-Center Randomized Trial

Ali Akil1, Michael Semik1, Stefan Freermann1, Jan Reichelt1, Bassam Redwan1, Dennis Görlich2, Stefan Fischer1
  • 1Department of Thoracic Surgery and Lung Support, Klinikum Ibbenbüren, Ibbenbueren, Germany
  • 2Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
Further Information

Publication History

27 April 2017

21 July 2017

Publication Date:
13 September 2017 (eFirst)


Background Video-assisted thoracoscopic surgery (VATS)-lung volume reduction surgery (LVRS) represents an important treatment option for patients with advanced lung emphysema. For VATS lung resection, endoscopic staplers are routinely used. Recently, a new generation of electronically powered stapling systems was developed. In this study, the iDrive powered stapling system (Covidien, Germany) was first tested during VATS-LVRS and compared with a non-electronic conventional device.

Methods Forty patients with advanced emphysema were enrolled in a prospective randomized trial. All patients underwent bilateral VATS-LVRS. Patients were randomized for iDrive use on the right lung (n = 20) or left lung resection (n = 20). A conventional endoscopic stapler (EndoGIA, Covidien) was used for contralateral resection in same patients. Therefore, 40 resections were performed with the iDrive and 40 with the EndoGIA. The duration of surgery, air leakage after extubation, and on postoperative day 1 (POD1), as well as length of chest tube therapy, were documented.

Results The application of the new system was uneventful. Mean duration of surgery was 52 ± 2.5 minute in the iDrive group compared with 54 ± 3.8 minute in the EndoGIA-group (p = 0.5). After extubation, the mean air leakage in the iDrive-group did not differ significantly from that in the EndoGIA-group (p = 0.6). This was also observed on POD1 (p = 0.7). Moreover, length of drainage therapy also did not show significant differences between both groups (p = 0.6).

Conclusion The iDrive powered stapling system offers one-handed, push-button operation, which eliminates the manual firing force and possibly enables more precise resection. In the current study, the novel system led to comparable results with the conventional mechanical stapler without any disadvantages in patients undergoing bilateral VATS-LVRS.


The German Society for Thoracic and Cardiovascular Surgery (DGTHG) and The Thoracic and Cardiovascular Surgeon neither endorse nor discourage the use of the new technology described in this publication.

Supplementary Material