VATS Left Upper Lobectomy

Thoracic surgeons who prefer an artery-first approach to VATS lobectomy generally find an incomplete fissure between the two lobes difficult to handle. It is also more difficult to perform a VATS left upper lobectomy, because there are more branches of the left upper pulmonary artery. If the surgeon dissects the hilar tissue from the anterior toward the posterior, or first dissects the vein and then the artery or bronchus, the surgeon can avoid the incomplete lung fissure problem, which makes the VATS approach much easier. Performing this procedure requires that the surgeon understand the hilar anatomy from different perspectives.