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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

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The VVBA method for thoracoscopic right middle lobe segmentectomy.

Min Zhang¹, Qing-Chen Wu¹, Ming-Jian Ge²

¹Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

General Thoracic and Cardiovascular Surgery

|June 4, 2020

Summary

This summary is machine-generated.

Thoracoscopic segmentectomy of small right middle lobe segments (RS4 and RS5) is challenging. A novel VVBA (vein, ventilation, bronchus, artery) method simplifies this procedure, proving safe and effective for these difficult lung resections.

Keywords:

Middle lobe segment RS4 Segmentectomy VVBA

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Area of Science:

Thoracic Surgery
Pulmonary Medicine
Surgical Techniques

Background:

The right middle lobe segments (RS4 and RS5) are anatomically small.
Segmentectomy techniques for these specific segments are infrequently documented.
Surgical access to small lung segments presents unique challenges.

Purpose of the Study:

To describe a novel technique for thoracoscopic segmentectomy of the right middle lobe segments (RS4 and RS5).
To evaluate the safety and efficacy of the VVBA method for RS4 segmentectomy.
To address the difficulties associated with incomplete lung fissures during segmentectomy.

Main Methods:

Three cases of thoracoscopic RS4 segmentectomy were performed using the VVBA (vein, ventilation, bronchus, artery) method.
The VVBA method involves sequential isolation and division of vascular, bronchial, and arterial structures.
Procedural steps were standardized for clarity and reproducibility.

Main Results:

The VVBA method facilitated thoracoscopic RS4 segmentectomy in all three cases.
The technique proved to be simple, safe, and effective.
It successfully managed the challenges posed by incomplete lung fissures.

Conclusions:

The VVBA method is a viable and advantageous approach for thoracoscopic RS4 segmentectomy.
This technique simplifies surgical procedures for small lung segments.
It offers a reliable solution for difficult segmentectomies in the right middle lobe.