Talk track

You mentioned identifying and addressing intra-operative air leaks can cause frustration, longer operating time and increased cost by applying adjuncts, and that minimizing air leaks is important to you. While you aren’t currently using a buttress, I would love to share some information with you about the latest buttress innovation that J&J Medtech has launched which is designed to assist surgeons to reduce patient complications, particularly air leaks. The ECHELON ENDOPATH™ Staple line reinforcement, otherwise known as SLR is a simple to use buttress made from the same trusted VICRYL™ and PDS™ materials that have been used for decades in suture materials. The evidence to support the use of ECHELON™ SLR spans across benchtop, pre-clinical, and clinical evidence.1,2,3,4 I want to focus particularly on the two clinical studies that have demonstrated that ECHELON™ SLR reduces PALs.1,2 An independent study in Japan recruited 48 patients who underwent a thoracic lobectomy and used ECHELON™ SLR during the procedure. This data was then compared with historical control data in an exploratory study. The ECHELON™ SLR group demonstrated a 6.3% PAL rate while the historical group demonstrated a 28.5% PAL rate.1 In addition, the ECHELON™ SLR group had a significantly shorter indwelling chest drainage time and length of hospital stay.1 A US study included 131 patients undergoing pulmonary resection in a single arm multi-centre prospective trial. The buttress was used on lung parenchyma but not on the bronchi or vessels. 5 patients (3.8%) treated with ECHELON™ SLR experienced PALs.2 However, the surgeons reported these AEs were either not related or unlikely related to the device. No patients experienced an empyema.2 This demonstrates that the use of ECHELON™ SLR can result in lower PAL rates than the reported rates in the literature of 5-19%.5 In addition, all the surgeons involved in the study reported they found ECHELON™ SLR easier to use than other available buttresses.2 This ease of use is a result of the simple 4 step application process which allows ECHELON™ SLR to stay securely attached to the staple reload, yet still gently release onto tissue.*3,4 And best of all it has no strings. I would be happy to share these papers with you to review. Would you be interested in trailing ECHELON™ SLR in 5-10 cases to see the results for yourself?

Key Messages

  • SLR has been demonstrated to reduce PALs in 2 clinical trials.1,2
  • A study in Japan showed PALs with the SLR group were 6.3% while the historical control group had a 28.5% PAL rate.1
  • A study in the US showed that PALs with the SLR group were 3.8% and they experienced no empymas. This is lowere than the reported rate of PALs in the literature of 5.6%-26%.5 The surgeons also reported they found SLR easier to use than their previous buttress choice.2
  • SLR is an easy 4 step process using a BAM which ensures the buttress stays in place during clamping, tissue manipulation and firing.*3,4
  • Ask for a 5-10 case trial so the surgeon can see the results for themselves.

References


*Based on coverage after manipulation assessment with SureForm™ 60mm devices.

1. Mitsui S, Tanaka Y, Nishikubo M, Doi T, Tane S, Hokka D, Mitomo Y, Maniwa Y Surgery Today 2024;54:779-86

2. Kesler KA, Zeltsman D, Martin LW, et al. J Thorac Disc. 2023;15(11):6151-6159.
3. Ethicon, Zeppelin Re-Imagined Coverage After Manipulation Assessment with SureForm 60mm Devices Completion Report. 06.07.2022. Windchill Document #500856806

4. Ethicon, Zeppelin Re-Imagine SureForm Release Test Completion Report. 04.06.2022. Windchill Document #5009082656. 
5. Zheng Q, Ge L, Zhou J, et al. Risk factors for prolonged air leak after pulmonary surgery: A systematic review and meta-analysis. Asian Journal of Surgery. 2022; 45:2159-2167.

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