Thoracoscopic fissureless left upper lobectomy for the patient with a dense fissure

The fissureless technique is a useful procedure for the treatment of patients with dense fissures because it reduces the risk of prolonged postoperative air leakage, which can lengthen postoperative hospitalization and increase medical costs. This technique is frequently utilized in right upper lobectomies because dense fissures are most commonly detected between the right upper and middle lobe, and consequently, there are multiple reports describing the efficacy of the fissureless technique in right upper lobectomy. However, there are relatively few reports discussing the efficacy of fissureless left upper lobectomy, and we have not found any reports or videos demonstrating the actual technique. We aim to fill this void here, with a demonstration of a thoracoscopic left upper lobectomy in a patient with dense fissures, and we also explain the nuances of performing this procedure.