Evaluation of a resorbable self-locking ligation device for performing peripheral lung biopsies in a caprine cadaveric model.

OBJECTIVE

To compare airway leak pressures after sealing peripheral lung biopsy sites with a resorbable ligation device (LigaTie) or thoracoabdominal (TA) staples.

STUDY DESIGN

Ex vivo study.

ANIMALS

Four normal caprine cadavers.

METHODS

Twelve lung lobes were harvested from 4 goats immediately after euthanasia. Each lobe was inflated to 20 cm H O to test for leaks prior to biopsy. Pressure was then maintained at 10 cm H O. Biopsy samples were obtained 3 cm from the periphery with a resorbable ligation device or a TA stapler (n = 6 per group). After biopsy, inflation pressure was slowly increased to 40 cm H O while lungs were submerged in water. The pressure at which bubbles were first seen was recorded as the airway leak pressure. The length, width, volume, and weight were recorded for each biopsy sample.

RESULTS

Five of 6 LigaTie biopsy sites sustained the maximum pressure of 40 cm H O without leaking. One site leaked at 24 cm H O. The TA-stapled sites sustained airway pressure to median 25.5 cm H O (interquartile range, 23.5-26 cm H O), and none of them reached the maximum pressure (P = .015). There were no differences in biopsy length, volume, or weight between groups.

CONCLUSION

Biopsy sites sealed with LigaTie withstood higher airway pressure without leaking compared with TA-stapled biopsy sites in normal cadaveric specimens.

CLINICAL SIGNIFICANCE

The LigaTie may be an alternative technique for sealing peripheral lung biopsy sites.