Review
doi: 10.21037/jtd.2018.05.207.Novel techniques for video-assisted thoracoscopic surgery segmentectomy
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- PMID:30034834
- PMCID: PMC6035921
- DOI: 10.21037/jtd.2018.05.207
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Review
Novel techniques for video-assisted thoracoscopic surgery segmentectomy
Mingyon Mun et al. J Thorac Dis.2018 Jun.
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Abstract
Small lung cancers are being increasing diagnosed because of advances in computed tomography (CT) and low-dose CT screening. Sublobar resection of peripheral, small lung nodules, such as ground-glass nodules, is a useful therapeutic option that obtains both a pathological diagnosis and radical cure. Lung segmentectomy is a better option than wedge resection for securing a sufficient surgical margin and can also be used to assess hilar nodes. Anatomical segmentectomy, however, is a technically more complicated operative procedure than standard lobectomy. We describe the issues and novel techniques of video-assisted thoracoscopic segmentectomy.
Keywords: Video-assisted thoracoscopic surgery; indocyanine green fluorescence; segmentectomy; three-dimensional reconstruction.
Conflict of interest statement
Conflicts of Interest: The authors have no conflicts of interest to declare.
Figures
Preoperative evaluation. (A) Thin-slice computed tomography shows a part solid ground-glass nodule (GGN) in right segment 2a; (B) a virtual intersegmental plane can be established.
Insufficient inflation–deflation line. (A) Segment 2 is inflated, and the other segments are deflated from the lateral aspect; (B) insufficient inflation–deflation line is seen to form a fissure.
Indocyanine green fluorescence images and the final aspect. (A) Right segment 2 appears dark, and the residual segment appears bright. The border between these two areas is recognized as the intersegmental plane (arrows); (B) final aspect after thoracoscopic right segment 2 segmentectomy.
Near-infrared thoracoscopy. (A) Pinpoint; Novadaq, Kalamazoo, MI, USA. Intersegmental plane (arrows); (B) Visera Elite II; Olympus, Tokyo, Japan. Clear contrast is observed, with the background also apparent. Intersegmental plane (arrows).
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