Right upper and middle lobe anomaly

Giulia Veronesi (Milano – Italy) A. Pardolesi

the video describes the robotic-surgical management of a lung anomaly consisting of unified right upper and middle lobes, with common bronchus and pulmonary vein, and anomalous course of pulmonary artery.
Intraoperative inspection of the lung through the robot?s 3D visual system showed absence of the middle lobe vein and absence of a fissure between the upper and middle lobes. After intraoperative review of the preoperative CT had confirmed absence of the right upper bronchus, the surgeons decided to complete the upper lobectomy robotically. Conversion to open surgery was not required. The hilum was approached anteriorly. Isolation of the pulmonary artery (PA) revealed two large PA branches in a single lobe, with no evidence of a separate PA branch to the middle lobe. The upper lobe vein was parted with a vascular stapler exposing a single common bronchus to the anomalous single lobe. The course of the main PA followed that of the left main PA.