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VATS Left Upper Lobe Apical and Posterior Bisegmentectomy
This video demonstrates a left upper lobe posterior and apical segmentectomy, preserving the lingular and anterior segment, in a patient with impaired lung function. The segmental pulmonary arteries are first identified, encircled, and taken with a stapler. Then the segmental bronchi are identified and stapled. This allows an excellent view of the pulmonary segmental veins. These are taken prior to inflation, to identify the line of stapling to complete the new fissure.
This is an excellent option for patients who have small tumors in the posterior or apical segments of the left upper lobe, in whom a full left upper lobectomy might significantly impair their long-term lung function. The posterior approach allows an excellent view of all the relevant segmental vessels.