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Anatomic segmental resection of the lung by thoracoscopy: an experimental study
K Koizumi1, T Akaishi, A Wakabayashi
1Department of Surgery, College of Medicine, University of California Irvine 92717, USA.
Surgery Today
|January 1, 1997
Summary
Thoracoscopic anatomical segmental resection is a feasible surgical option for lung cancer when lobectomy is not possible. Further technique refinement is needed before human clinical trials can begin.
Area of Science:
- Thoracic Surgery
- Minimally Invasive Procedures
- Surgical Oncology
Background:
- Lobectomy is standard for small peripheral lung cancers, but not always feasible.
- Anatomical segmentectomy offers potential advantages over wedge resection due to lymphatic preservation.
- Thoracoscopic approaches are increasingly used for lung resections.
Purpose of the Study:
- To evaluate the technical feasibility of anatomical segmental resection using thoracoscopy.
- To assess the safety and operative parameters of thoracoscopic segmentectomy in a porcine model.
Main Methods:
- Segmental resections were performed on porcine lungs via thoracoscopy.
- Vessels were ligated, bronchi stapled, and parenchyma divided using lasers and dissectors.
- Forty-three pigs underwent resection of specific lung segments (S1+2, S3, upper/lower divisions, S6, S8, S9+10).
Main Results:
- Thoracoscopic segmentectomy was technically feasible across all tested lung segments.
- Operating times ranged from 145 to 191 minutes, with blood loss between 36-151 ml.
- Significant blood loss occurred during intersegmental plane division, particularly in S6 and S9+10 resections.
Conclusions:
- Thoracoscopic anatomical segmentectomy is technically achievable.
- Further technical improvements are necessary before clinical application in humans.
- This minimally invasive technique shows promise for lung cancer treatment when lobectomy is contraindicated.