The use of an electrothermal bipolar tissue sealing system in the management of lung hydatid disease.

Surgery is the treatment of choice for management of pulmonary hydatid cysts. Total pericystectomy provided the best results concerning the recurrence of the disease, but haemorrhagia and air leak during dissection of the pericystic space are the main disadvantages of such a method. To avoid these complications, we proposed the use of an electrothermal bipolar tissue sealing system. After the extraction of the hydatid cyst, a small space is created between the pericyst and normal lung, and the separation between the two zones is joined using the electrothermal bipolar tissue sealing system. This procedure reduces the risk of bleeding and of air leaks because the bronchi and the vessels encountered during dissection are sealed by the electrothermal bipolar tissue sealing system. When the pericystic membrane (inflammatory host reaction) is intimately adherent to the lung, total pericystectomy demands greater technical training because the bronchovascular axes of the healthy segments are situated in the pericyst. In such cases, the electrothermal bipolar tissue sealing system allowed creation of an appropriate plane through the parenchyma close to the pericyst, minimizing the normal lung exposed to resection as much as possible and reducing the resulting bleeding and air leak. This procedure was successfully applied in 4 consecutive patients each with a giant hydatid cyst.