[Knack and Pitfalls of Bronchoplasty and Pulmonary Arterial Plasty]

Surgical techniques of bronchoplasty and pulmonary arterial plasty are sometimes necessary to preserve pulmonary function in thoracic surgery patients although they are not common procedures. There are multiple patterns of plasty, but the basic techniques are common. Bronchus and pulmonary artery anastomoses are always performed at the time of lung transplantation. Therefore, we can learn the fundamental techniques from lung transplantation. In this chapter, I describe the knack and pitfalls of plasty and anastomoses of bronchus and pulmonary artery based on the knowledge and techniques of lung transplantation we practice at the University of Tokyo Hospital. For example, surgeons should not grab the bronchus wall with forceps to avoid the wall damage since it possibly causes postoperative stenosis. How to hold the needle, how to move your wrist and arms and where you stand are also important to handle the needle as you imagine. Your forceps can also be a great help for your needle handling. It is not difficult to obtain the techniques. You only need to consider that every movement matters. Your hands, your arms, your standing position and your assistant' are all important to have satisfactory results.