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Right Upper Lobe Microlobectomy With the Double Double

Wednesday, May 1, 2019

Dunning J. Right Upper Lobe Microlobectomy With the Double Double. May 2019. doi:10.25373/ctsnet.8049749.

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

  1. Dunning J, Elsaegh M, Nardini M, et al. Microlobectomy: a novel form of endoscopic lobectomy. Innovations (Phila). 2017;12(4):247-253.

Comments

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.

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