Uniportal thoracoscopic posterior basal (S10) segmentectomy using a posterior approach

Area of Science:

• Thoracic Surgery
• Minimally Invasive Surgery
• Pulmonary Surgery

Background:

• Posterior basal (S10) segmentectomy via a single port is technically demanding due to the S10 segment's dorsal location and deep positioning away from the major fissure.
• Conventional approaches may require extensive parenchymal splitting, increasing risks of misidentification of segmental structures and unnecessary tissue damage.

Discussion:

• This study introduces a uniportal thoracoscopic S10 segmentectomy using a posterior approach, minimizing parenchymal dissection from the interlobar fissure.
• The posterior approach facilitates direct visualization and stapler placement towards the target S10 segmental vessels and bronchi.
• Division of parenchyma between segments S6 and S10 from the dorsal aspect provides excellent exposure of the segmental pulmonary artery (A10).

Key Insights:

• A novel posterior approach for uniportal thoracoscopic S10 segmentectomy is described.
• This technique enhances visualization and simplifies the resection of deep-seated S10 segmental structures.
• The method effectively exposes the segmental pulmonary artery (A10) while minimizing parenchymal manipulation.

Outlook:

• This approach may offer a safer and more efficient alternative for complex S10 segmentectomies.
• Further studies could explore the long-term outcomes and broader applicability of this technique in various patient populations.
• Refinement of uniportal techniques continues to advance minimally invasive thoracic surgery.