Complete Division of the Right Upper Lobe Vein with an Energy Device in a Microlobectomy

This video demonstrates a right upper lobe microlobectomy. It illustrates the complete division of the right upper lobe vein using only the Ethicon Enseal, a bipolar energy device. Only 5 mm instruments should be used in the intercostal spaces during a microlobectomy. For this reason, an energy device such as Enseal or Ligasure, may be a good alternative to a 12 mm stapler, Cardica microcutter, or Haemalock clips for dividing all the vessels from the subxiphoid port.

The key elements of microlobectomy are:

• No incisions in the intercostal spaces larger than 5 mm
• A 12 mm subxiphoid port
• Subxiphoid removal of the resected specimen, above the diaphragm
• CO² insufflation
• Vision through a 5 mm camera
• Stapling of vascular structures using the Cardica 5 mm MicroCutter

For more information on microlobectomy, click here. 

Disclosure: Mr. Dunning has received payment for giving a talk on microlobectomy to Cardica employees. Mr. Dunning has not recieved support from Ethicon or Covidien.