Segmentectomies involving the posterior basal segment (S10) of the lower lobe present a challenging surgical procedure due to anatomical complexities, especially when lesions extend towards the lateral basal segment (S9). We introduce a combined subsegmentectomy technique via a posterior approach for a lesion situated between S9b and S10b, which preserves subsegmental branches that do not affect the resection margin of the tumour and facilitates intersegmental division without extending dissection into the interlobar region. This technique, the goal of which is to reduce the extent of dissection and complex stapling, is expected to minimize pulmonary complications and intrathoracic adhesions without compromising oncological outcomes. By potentially mitigating challenges in an ipsilateral reoperation, this approach offers a valuable alternative for managing second lung cancers.
Keywords: 3D simulation; Anatomic sublobar resection; Combined subsegmentectomy; Indocyanine green; Intersegmental plane; Less invasive surgical technique; Lung cancer; Lung parenchyma-saving resection; Minimally invasive thoracic surgery; Pulmonary segmentectomy; RATS; Uncommon segmentectomy; Unidirectional dissection.
© The Author 2024. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.