Low-thermal coagulation of pulmonary bullae by general- purpose radiofrequency cautery device in pneumothorax surgery

Radiofrequency cautery is widely used in minor surgery. However, it has not been considered to fit for major surgery. Herein, we report two cases of pneumothorax surgery using lowthermal coagulation by this general-purpose radiofrequency cautery device. Case 1: A 47-year-old male underwent bullectomy with a general radiofrequency cautery. We used Elleman® Surgitron PellevéTM S5 (Elleman International, Inc., Hicksville, NY) with a ball-shaped electrode tip (5mm in diameter, 110mm in length, Erbe Elektromedizin GmbH, Tübingen, Germany) for surgical coagulation of emphysematous bullae and abrasion of apical parietal pleura. Case 2: A 65-year-old female also underwent pneumothorax surgery with radiofrequency cautery. Pathological findings: Each coagulated bulla wall was degenerated, thickened, and turned into non-structured tissue by heat infiltration at low temperature of radiofrequency. This degeneration of collagen fibers was observed only within 2mm from the pleural surface. Conclusion: Radiofrequency cautery made the bulla wall thickened and degenerated without damaging the lung parenchyma. Correspondence to: Takashi Iwata, MD, Ph. D, Director, Department of General Thoracic Surgery, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 650-8511, Japan, Tel: +81-6-6416-1221; Fax: +81-6-6419-1870; E-mail: [email protected]