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Updated: Jun 23, 2026

Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
Published on: February 27, 2026
[Surgical contrivance for bronchoplasty; U-shape mattress interrupted suture with pledgets]
Noriyuki Takahashi1, K Tsunematsu, A Suzuki
1Department of Thoracic Surgery, Hokkaido Tomakomai Hospital, Tomakomai, Japan.
Abstract:
There are some nuisance complications concerning inadequate adaptation of the anastomosis after bronchoplasty, such as air leakage, stenosis and granulation. These causative factors could be that the cartilaginous portion, which depend on diffusion from the submucosal capillary plexus, was used for the anastomosis stump and suture materials lingered on the anastomosis line. In this time for the aim to avoid these potential problems we used the mucosa surface, which was supplied by abundant vessele, for an extroversional mattress suture. Therefore we contrived a new technique, U-shape mattress interrupted suture (mucosa extroversional suture) using 3-0 PDS or Maxon with pledgets. It enables to make both enough margins of the bronchial mucosa surfaces touch tightly and to prevent sutures from lacerating the graft during using knot pusher. We have performed this procedure to 8 times in 7 cases (sleeve lobectomy 3, sleeve segmentectomy 1, bronchial resection 2, lobectomy + bronchial wedge plasty 2) and could acquire excellent outcome.
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