This is a right upper lobe microlobectomy and the author uses the stapler to perform a double stapling twice, hence the “Double Double!”
The procedure shown in this video is the microlobectomy technique, which is fully described at www.microlobectomy.com (1).
The author did a lymphadenectomy, then dissected out the right upper lobe vein and the truncal branch of the pulmonary artery. He transected both of these vessels with a single Tan 45 stapler from the subxiphoid port.
The author then dissected out the posterior ascending artery and the right upper lobe bronchus, again dividing them both with a single stapler as they lined up very nicely with the stapler coming from the subxiphoid port.
The author also used the Surgiwand™ (Covidien, Dublin, Ireland) in this video. It is a hook diathermy and also a sucker in one, which means that one does not have to remove the hook from the surgical field when they want to do some suction.
References
- Dunning J, Elsaegh M, Nardini M, et al. Microlobectomy: a novel form of endoscopic lobectomy. Innovations (Phila). 2017;12(4):247-253.
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1 Comment
thank you so much for the video, Dr. Dunning. Its a great way to save a cartridge of staple. I have seen this technique used in Uniportal Rt. UL in SPH. Once you remove the LN in between the truncal artery and the vein, you can do it. I am not sure you can do this on any other lobe. But not for PAA and bronchus. That’s a first. Good job.