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Instruments for thoracic procedures

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Long Bipolar Grasper

There are a couple choices for the bipolar energy dissection.  I prefer to use bipolar, however monopolar is available.  Intuitive has a Maryland, Curve Bipolar Dissector and Long Bipolar Dissector.  

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Hook

There are a couple choices for the bipolar energy dissection.  The hook is useful in certain circumstances.  I think it helps to control small vessel bleeding.  Many utilize it even for precise LN dissection.  

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Tip-Up Fenestrated

This is the most usefull instrument for the 3rd arm and general retraction.  Atraumatic to the lung tissue but consider utilizinf a Kittner Cigar in the grasper to help with retraction. 

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Vessel Sealer

This is the typical energy device like the Ligasure or Enseal.  Divids up to 7 mm.  I use it for small venous or arterial branches.  Also useful for thymectomy and foregut procedures.

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Cadiere

Left hand atraumatic grasper.  Since it is blunt it assists in gentle dissection around vessels.  There is the Force Bipolar varient that has a atraumatic setting and stronger grip (traumatic) with the addition of bipolar use.  

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SyncroSeal

This is Intuitive new energy device that is an extension of the vessel sealer line.  We have not used it as of yet but hope to incorporate it as a dissector and sealer in one.  

optional recommendations

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Cigar Kittner

This is the most usefull instrument for the 3rd arm and general retraction.  Atraumatic to the lung tissue but consider utilizinf a Kittner Cigar in the grasper to help with retraction. 

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LN Baglet

Glove tips are useful to insure that the LN doesn't get caught in the port or if dropped is easier to locate. 

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Local Needle

This is an aspirating needle used for navigational bronchoscopy, however it works quite well to inject 2-4 mL 0.5% Marcaine for a direct intercostal nerve block (Covidien 21G Aspirating Needle)

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Red Rubber Lead

Easy on and off guide for the stapler.  Placing this as a guide behind a vessel and with the stapler following behind inproved safety.

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Hassan

Useful for foregut surgeries.  There is a longer port as well for the higher BMI patients. 

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