Trans-Inferior-Pulmonary-Ligament Single-Direction Thoracoscopic RS9 Segmentectomy: Application of Stem-Branch Method for Tracking Anatomy.

Annals of Surgical Oncology
Yunke ZhuLunxu Liu

Abstract

Video-assisted thoracoscopic segmentectomy has become a safe and effective surgical approach for stage IA non-small cell lung cancer.1,2 Therein, thoracoscopic segmentectomy for the lateral basal segment (S9) is the most technically challenging anatomical segmentectomy.3-6 Because the target vessels and bronchus are commonly variable and deeply located in the lung parenchyma, it is difficult to expose and correctly identify them through either an interlobar fissure approach or a posterior approach. Meanwhile, tailoring the intersegmental plane is another challenge that is encountered in a VATS S9 segmentectomy. In this multimedia article, we present a thoracoscopic right S9 segmentectomy following the single-direction strategy through an inferior pulmonary ligament approach, using a novel method named stem-branch to track the target segmental branches along the stem (video).7 The positional relations of the basal segmental vessels and bronchi were preliminarily identified mainly through the high-resolution computed tomography (HRCT). The surgery was initiated through an inferior pulmonary ligament approach. The stems of the basal segmental vein and bronchus were first dissected, followed by dissection of their branches. Then, t...Continue Reading

References

May 26, 2009·The Journal of Thoracic and Cardiovascular Surgery·Mark ShapiroScott J Swanson
Feb 18, 2010·Annals of Surgery·Juan P WisniveskyEthan A Halm
Dec 4, 2014·The Journal of Thoracic and Cardiovascular Surgery·Takuma KikkawaTakamasa Onuki
May 4, 2017·The Journal of Thoracic and Cardiovascular Surgery·Makoto EndohMitsuaki Sadahiro
Jul 10, 2019·The Annals of Thoracic Surgery·Qiang PuLunxu Liu

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Citations

Sep 25, 2021·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Nobuyuki YoshiyasuToru Bando

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