Robot-Assisted Lingula-Sparing Left Upper Lobectomy: Segmental Plane Identification Using Near-Infrared Fluorescence Imaging

In this video, the authors present a robot-assisted lingula-sparing left upper lobectomy, using segmental plane identification with near-infrared fluorescence imaging. During this procedure, the arterial and venous vasculature, along with the bronchial segments to the apico-posterior and anterior segments of the left upper lobe, are identified and divided. Once the upper divisions have been devascularized, 5-10 mg of indocyanine green is infused intravenously. Using near-infrared fluorescence imaging technology, the lung parenchyma is inspected. The well-vascularized lingula fluoresces brightly in contrast to the devascularized apico-posterior and anterior segments. The intersegmental plane separating the lingula and upper divisions is easily identified, which facilitates this lingula-sparing sublobar resection.