Reinforcement of a bronchial stump in VATS lobectomy

Bronchial stump reinforcement is sometimes required for patients who have a high risk of developing a bronchial fistula. A lobectomy by video-assisted thoracic surgery (VATS) is widely used for the treatment of both stage I primary lung cancer and metastatic central lung cancer, but there has been no report on reinforcement of a bronchial stump in a VATS lobectomy. We report an aged patient with stage I primary lung cancer concomitant to diabetes mellitus who was successfully treated by VATS lobectomy with reinforcement of the bronchial stump using a pericardial fat pedicle flap. A Harmonic scalpel was very useful and effective in harvesting the fat pedicle.