Stem-Branch: A Novel Method for Tracking the Anatomy During Thoracoscopic S9-10 Segmentectomy

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Pulmonary Anatomy

Background:

• Anatomic segmentectomies, particularly S9-10, present significant technical challenges in thoracoscopic surgery.
• Deeply located and variable segmental bronchi and vessels complicate exposure and identification using traditional interlobar fissure or posterior approaches.

Purpose of the Study:

• To present a novel method for single-direction thoracoscopic S9-10 segmentectomy.
• To improve the identification and tracking of target segmental branches during complex lung resections.

Main Methods:

• Description of a new technique utilizing an inferior pulmonary ligament approach.
• Tracking of target segmental vessels and bronchi along their stems during the procedure.

Main Results:

• The inferior pulmonary ligament approach facilitates easier tracking of S9-10 segmental branches.
• This method simplifies the exposure of deeply located and variable structures within the lung parenchyma.

Conclusions:

• The described inferior pulmonary ligament approach offers a viable solution for technically demanding thoracoscopic S9-10 segmentectomies.
• This novel technique enhances the safety and efficiency of complex lung segment resections.