Left lower lobe plus segment of upper lobe

Giulia Veronesi (Milano – Italy) A. Tessitore

This video shows the technique of a left lower robotic lobectomy en bloc with segment of the upper lobe for a lung adenocarcinoma that involved the fissure . The approach to the hylum started posterioriorly with the dissection of the pulmonary artery from lymph nodes and adeshions with the lung tumor. The second phase was the isolation of the artery in the fissure after retracting the lung posteriorly. Other interlobar lymph nodes were removed , the artery branches for the lower lobe were than isolated and encycled, one small branch for the posterior segment of the upper lobe was sectioned trought hemolock clips. The posterior fissure was completed using the endostaplers involving a part of the upper lobe to include all the cancer, the arteries for the lower lobe were transected with one endostapler cartridge . The third phase was the isolation and section of the pulmonary vein with the endostapler and the lobectomy was completed with the resection of the lower bronchus after removal of the peribronchial lymph nodes. Lymph node dissection of station 5 was shown at the end.