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Thoracoscopic apical segmentectomy, right upper lobe.

George Rakovich1, Julien Hubert Hubert

  • 1Hôpital Maisonneuve-Rosemont (University of Montreal) 5415, l'Assomption Montréal, QC, H1T 2M4, Canada.

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Minimally invasive pulmonary segmentectomy offers effective lung cancer treatment while preserving lung tissue and reducing recovery time. This thoracoscopic approach provides versatile access for complex resections and intraoperative adjustments.

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Minimally invasive pulmonary segmentectomy is a lung-sparing surgical technique for selected lung cancer cases.
  • It aims to reduce perioperative morbidity and hospital stay compared to traditional resections.
  • Variations exist, but a multiport thoracoscopic approach offers advantages in access and adaptability.

Observation:

  • The study details a fully thoracoscopic multiport approach for pulmonary segmentectomy.
  • Key technical aspects include patient positioning, trocar placement, and standardized dissection of segmental structures.
  • The technique emphasizes accurate division of the intersegmental plane for procedures like right apical segmentectomy.

Findings:

  • This approach allows adequate oncologic treatment by resecting lung segments or multiple segments (bisegmentectomies).
  • The multiport technique provides direct access to segmental arteries and bronchi.
  • It is versatile, allowing for intraoperative conversion to lobectomy if needed, such as for positive margins.

Implications:

  • Pulmonary segmentectomy preserves healthy lung parenchyma, crucial for patients with compromised lung function.
  • Minimally invasive techniques improve patient outcomes by minimizing surgical trauma and shortening hospital stays.
  • Standardized thoracoscopic approaches enhance the feasibility and safety of complex segmentectomies.