Subxiphoid Right Upper Lobectomy

This is a video of a right upper lobectomy done through a subxiphoid port. The patient had an incidental finding of a mass on a chest x-ray, which CT-guided biopsy later confirmed to be a poorly differentiated adenocarcinoma. A 4 cm subxiphoid incision was made in the midline using the xiphisternum and subcostal margin as landmarks. The xiphisternum was excised, and the incision was dissected internally to create a retrosternal tunnel. First, the anterior truncus of the pulmonary artery was dissected and divided. Next, the vein and the bronchus were dissected. The fissures were partly divided. Then the posterior ascending pulmonary artery was dissected and divided. The fissures were completed and the specimen was removed. Finally, there was some lymphadenectomy.