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Port-access thoracoscopic anatomical right anterior segmentectomy
Hiroyuki Oizumi1, Hirohisa Kato1, Makoto Endoh1
1Second Department of Surgery, Yamagata University, Yamagata, Japan.
Journal of Visualized Surgery
|October 28, 2017
Summary
Thoracoscopic lung segmentectomy using 3D CT simulation and a novel slip-knot technique achieves a 99% success rate. This method enables precise dissection and reduces surgical time for lung cancer treatment.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Surgical Oncology
Background:
- Thoracoscopic lung segmentectomy is a complex procedure with varied definitions.
- Human lungs have 18 distinct anatomical segments, making segmentectomy procedures diverse.
Purpose of the Study:
- To evaluate a novel method for thoracoscopic lung segmentectomy.
- To assess the efficacy and safety of 3D CT simulation and a slip-knot technique in segmentectomy.
Main Methods:
- Developed a pulmonary segmentectomy method using 3D multidetector computed tomography (CT) simulation.
- Performed 248 port-access thoracoscopic anatomic lung segmentectomies.
- Utilized a slip-knot technique for intersegmental plane delineation since 2010, identifying planes via intersegmental veins and lung inflation/deflation.
Main Results:
- Achieved a 99% success rate for complete thoracoscopic segmentectomy.
- Minithoracotomy was needed in two cases due to arterial bleeding.
- No tumor recurrences were observed in patients undergoing curative-intent resection for lung cancer.
Conclusions:
- Multidetector CT-guided thoracoscopic lung segmentectomy allows for precise parenchymal dissection.
- The slip-knot technique simplifies intersegmental plane creation, reducing surgical duration.
- Presents a case of successful port-access anatomical resection using a vessel sealing system.
