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Related Experiment Video

Updated: Aug 25, 2025

Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique
03:48

Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique

Published on: October 6, 2023

1.0K

Thoracoscopic right-S10 segmentectomy: Alternative posterior approach.

George Rakovich1

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

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|October 14, 2022
PubMed
Summary

A posterior approach offers improved access for S10 segmentectomies, simplifying dissection of the vein and bronchus. This method, guided by advanced imaging, enhances surgical precision for this challenging procedure.

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Area of Science:

  • Thoracic surgery
  • Pulmonary anatomy
  • Surgical techniques

Background:

  • Segmentectomies, particularly of the S10 segment, present significant surgical challenges.
  • Traditional anterior approaches for S10 segmentectomies can be difficult due to limited access.
  • Understanding the complex bronchovascular anatomy of the lower lung is crucial for successful segmentectomy.

Discussion:

  • A posterior approach provides direct access to the S10 vein and bronchus.
  • Dividing the posterior intersegmental plane (S6-S10) facilitates this approach.
  • The inferior pulmonary vein trunk serves as a key landmark, delineating the segmental bronchus.

Key Insights:

  • The posterior approach is favored for S10 segmentectomies due to enhanced anatomical visualization and access.
Keywords:
Anatomic sublobar resectionSegmentectomyThoracoscopyUncommon segmentectomy

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  • Cross-sectional imaging and 3D reconstructions are vital for preoperative planning and intraoperative guidance.
  • Precise identification of the segmental artery, typically deep to the bronchus, is essential.

    • Outlook:

    • Continued refinement of surgical approaches for challenging segmentectomies is necessary.
    • Advanced imaging integration will further improve safety and efficacy in pulmonary surgery.
    • Minimally invasive techniques for complex segmentectomies will likely evolve.