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Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer

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Slip knot bronchial ligation method for thoracoscopic lung segmentectomy.

Hiroyuki Oizumi¹, Hirohisa Kato¹, Makoto Endoh¹

¹Second Department of Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.

The Annals of Thoracic Surgery

|April 4, 2014

Summary

A new slip knot technique simplifies bronchial ligation for lung segmentectomy. This method aids in visualizing the anatomic plane, improving surgical precision during thoracoscopic procedures.

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Area of Science:

Thoracic Surgery
Surgical Techniques
Pulmonary Medicine

Background:

Lung segmentectomy requires precise identification of intersegmental planes.
Current methods for bronchial ligation can be cumbersome during thoracoscopic procedures.

Purpose of the Study:

To introduce a novel monofilament slip knot technique for bronchial ligation.
To enhance visualization of the anatomic plane during lung segmentectomy.

Main Methods:

A slip knot is created outside the thorax after threading the bronchus.
The knot is advanced to the bronchus by pulling a string during lung ventilation, eliminating the need for a knot-pusher.
Bronchial ligation is performed to isolate segmental air outflow.

Main Results:

The technique allows the target segment to remain expanded while others collapse.
Facilitates clear identification of the anatomic intersegmental plane.
Enables precise thoracoscopic anatomic lung segmentectomy.

Conclusions:

The novel slip knot technique offers a simpler and more effective approach to bronchial ligation.
Improved visualization of intersegmental planes enhances the safety and accuracy of lung segmentectomy.
This technique is particularly beneficial for thoracoscopic lung segmentectomy procedures.