Totally thoracoscopic left upper lobe tri-segmentectomy.

Ann Cardiothorac Surg 2014;3(2):197-201 www.annalscts.com With continued growing interest in sublobar resections from the international surgical community (1,2), mastering thoracoscopic segmentectomy is an important challenge for the surgeon. With respect to sublobar resections of the left upper lobe, it is now considered that for T1 tumors, a lingual-sparing upper lobectomy is oncologically equivalent to an upper lobectomy (3). The main segmental resections involving the left upper lobe are: tri-segmentectomy (S1 + S2 + S3) (lingula-sparing lobectomy), apicoposterior segmentectomy (S1 + S2) and lingulectomy (S4 + S5). In this article, we will describe the technique of a full thoracoscopic approach and illustrate it with a video. Lymph node dissection is similar to lymphadenectomy for an upper lobectomy and hence will not be described here.