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Updated: Jul 20, 2026

Laparoscopic Anatomical Resection of the Right Anterior Lobe Based on the Laennec Capsule Technique

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Thoracoscopic Right Lower Lobectomy With Right Top Pulmonary Vein: Safe Subcarinal Lymph Node Dissection.

Reo Ohtsuka¹, Tadasu Kohno¹, Sho Horiuchi¹

¹Department of Thoracic Surgery, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan.

Interdisciplinary Cardiovascular and Thoracic Surgery

|March 21, 2026

Summary

A rare right top pulmonary vein (RTPV) anomaly poses risks during right lower lobectomy. This case demonstrates safe thoracoscopic surgery using specific techniques to preserve the vein and perform lymph node dissection.

Keywords:

right top pulmonary vein subcarinal dissection video-assisted thoracic surgery

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Area of Science:

Thoracic Surgery
Vascular Anatomy
Surgical Techniques

Background:

The right top pulmonary vein (RTPV) is a rare venous anomaly.
Its dorsal course to the bronchus intermedius increases risks during right lower lobectomy, especially during subcarinal lymph node dissection and fissure division.

Purpose of the Study:

To describe a thoracoscopic right lower lobectomy with subcarinal lymph node dissection in a patient with RTPV.
To highlight practical strategies for preserving anomalous veins and ensuring safe subcarinal lymph node dissection.

Main Methods:

Thoracoscopic right lower lobectomy.
Circumferential dissection of the RTPV.
Fissure-last technique for lung resection.
Subcarinal lymph node dissection.

Main Results:

Successful thoracoscopic right lower lobectomy was performed.
The anomalous right top pulmonary vein was preserved.
Safe subcarinal lymph node dissection was achieved.

Conclusions:

Specific techniques, including circumferential dissection and a fissure-last approach, enable safe management of RTPV during thoracoscopic right lower lobectomy.
These strategies contribute to technically reproducible thoracoscopic surgery for complex venous anomalies.