Uniportal thoracoscopic lateral and posterior (S9+10) segmentectomy using a modified intersegmental tunneling...

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Innovation

Background:

• Lateral and posterior basal (S9+10) segmentectomy is technically demanding due to deep anatomical structures.
• Existing uniportal approaches require precise identification of pulmonary vessels and bronchi.

Discussion:

• A modified intersegmental tunneling technique was developed for S9+10 segmentectomy.
• This approach involves tunneling and dividing the intersegmental plane before vessel and bronchial division.
• The modification aims to improve visualization and facilitate stapler use.

Key Insights:

• The modified tunneling procedure enhances recognition of critical pulmonary structures.
• Division of vessels and bronchi was smoother with the modified technique compared to previous versions.
• The technique addresses stapler tip adherence issues encountered previously.

Outlook:

• This modified technique may offer a universally preferable approach for S9+10 segmentectomy.
• It has the potential to increase accessibility for surgeons with less experience in complex segmentectomies.
• Further studies could validate its broad applicability and long-term outcomes.