Total thoracoscopic lung segmentectomy of anterior basal segment of the right lower lobe (RS8) for NSCLC stage IA (case report)

Abstract

A 69-year-old woman with a pulmonary nodule in anterior basal segment of the right lower lobe (RS8) was referred to our department. The diameter of the tumor was 12 mm, and it had increased over a few months. First, video-assisted thoracoscopic lung surgery (VATS) biopsy of the pulmonary nodule was carried out. Frozen section examination of this nodule confirmed the diagnosis of bronchioloalveolar carcinoma (BAC). Segmentectomy of RS8 with lower mediastinal node dissection (ND2a-1) was performed. The intersegmental plane was identified using the intersegmental veins as landmarks and the demarcation between the resected (inflated) and preserved (collapsed) lungs. Electrocautery at 70 watts was used to divide the intersegmental plane. A vessel sealing system was used to seal and cut the pulmonary arteries. Postoperative histopathological examination revealed that the tumor was T1aN0M0 BAC, and the minimal distance between the surgical margin and the tumor edge was 15 mm. The patient was discharged from hospital on postoperative day 5 without any complications.

Self‑made thoracic needled suspending device with a snare: An excellent aid for uniportal video‑assisted thoracic lobectomy and segmentectomy for lung cancer

“…Rocco (3) reported uniportal video-assisted thoracic surgical resections in 2004. Miyajima et al (4) and Okada (5) reported uniportal video-assisted thoracic lobectomy and segmentectomy in 2011 and 2012, respectively. Uniportal video-assisted thoracic surgery is a trend of endoscopic surgery.…”

The application of virtual segmentectomy based on three-dimensional computed tomography and angiography in thoracoscopic segmentectomy for children and infants

“…According to the anatomic landmarks shown on the 3D-CTBA images before operation, the target vessels and bronchi were dissected from superficial to deep (Figs. 2,3,4,5,6,7,8,9,10,11,12 and 13). The resection of the lower lobe is usually done through the hilum, while the lower lobe is generally removed from anterior to the pericardium.…”

“…There are many anatomical variations in the blood vessels and bronchi of the lung, which makes the operation more difficult [6]. Three-dimensional computed vascular scanning (3D-CTBA) reconstruction of pulmonary vessels and bronchi can clearly show the anatomical structure of the lung [6][7][8][9]. We applied it to the complex segmental pneumonectomy, simulated segmental resection before the operation, and precise segmental resection regarding the reconstructed images during the operation.…”

Anatomic thoracoscopic segmentectomy for early-stage lung cancer

“…In addition to the traditional two-, three-, or four-port approach to VATS segmentectomy, a few small case series have reported results on the "totally thoracoscopic" or "complete VATS" technique for segmentectomy (20)(21)(22)(23)(24)(25)(26)(27). This technique involves no access incision and retrieval of the specimen is through one of the port sites that is enlarged at the end of the procedure (28).…”