Video assistant thoracoscopic (VATS) lobectomy: right lower lobe

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Medical Imaging

Background:

• A 60-year-old female presented with a lung nodule in the right lower lobe.
• Diagnostic imaging, including CT and PET-CT, confirmed the nodule as a tumor.

Observation:

• A right lower lobectomy was performed using video-assisted thoracoscopic surgery (VATS).
• A novel posterior trocar placement was utilized in the 5th intercostal space within the anterior latissimus dorsi.
• The patient exhibited vessel heteromorphosis, with shared stems for the inferior and mid pulmonary veins.
• Enlarged lymph nodes (intumescentia lymph nodes) were observed.

Findings:

• The unique trocar placement facilitates minimally invasive access through a small incision.
• Complete ablation of intumescentia lymph nodes was successfully achieved via VATS.
• The surgical procedure addressed both the primary lung tumor and associated lymphadenopathy.

Implications:

• This case demonstrates the feasibility and effectiveness of VATS for complex lung resections with lymph node involvement.
• The described surgical technique offers a potentially less invasive approach for future thoracic procedures.
• Understanding pulmonary vessel variations is crucial for safe and efficient thoracoscopic lung surgery.