A new study showed a near 50% reduction in bleeding complications when comparing powered vs manual stapler during video-assisted thoracoscopic surgery (VATS) for lung cancer. It also found a nearly 10 percent reduction in total hospital costs and one day sooner discharge from the hospital associated with the powered-stapling procedures.
The starting point is that between 2 and 10 percent of lobectomies result in bleeding complications. A new study in the peer-reviewed journal, Advances in Therapy, is titled “Impact of Powered and Tissue-Specific Endoscopic Stapling Technology on Clinical and Economic Outcomes of VATS Lobectomy Procedures.” Funded by J&J’s Ethicon, it aimed to compare powered staplers (predominantly Ethicon’s Echelon Flex) with manual alternatives.
Researchers evaluated hospital discharge data of more than 3,550 thoracic patients from more than 700 hospitals that contribute to the Premier Healthcare Database, one of the largest statistically-certified hospital databases in the world. Patients had VATS lobectomy procedures with either powered staplers (659 patients) or manual staplers (3,100 patients) between January 2012 and September 2016. Of the powered staplers used in the study, over ninety-nine percent were Ethicon’s Echelon Flex powered staplers. Of the manual staplers used in this study, over seventy-five percent were manufactured by Medtronic, with the balance being manufactured by Ethicon.
Analysis showed that VATS lobectomy patients had nearly half the rate of hemostasis-related complications (8.5 percent vs.16 percent) of manual staplers and were hospitalized for estimated 4.9 days versus 5.9 days. Total adjusted hospital costs were about 9 percent more for procedures performed with manual staplers ($26,052 vs. $23,841). Outcomes including discharge status, operating room time and hospital readmissions were not different between the two groups.
“This real-world study shows stapler choice really does matter in significantly reducing bleeding complications and lowering overall costs in VATS lobectomy procedures. The results in favor of powered stapling devices in thoracic surgery are compelling,” said lead study author Daniel L. Miller, MD, Chief, General Thoracic Surgery at WellStar Health System, Mayo Clinic Care Network in Marietta, GA.
“We continue to take aim at critical clinical issues such as hemostasis complications through the development of innovative devices like ECHELON FLEX Powered Staplers and the generation of meaningful clinical and real-world evidence that fills knowledge gaps, validates outcomes and better informs everyday decision making,” said Edmund Kassis, MD, Ethicon Sr. Medical Director for Thoracic Surgery.