Abstract
Left upper lobectomies are reputed to be hazardous, because of the need to control the mediastinal branches of the pulmonary artery, which can be short and fragile. Any tear would cause massive hemorrhage and would require immediate conversion to thoracotomy. However, thanks to the close-up vision and magnification provided by the thoracoscope, dissection can be accurate and safe. Most of the dissection is performed from behind, including control of the truncus anterior. But the technique should be adapted to the anatomical conditions, and an anterior dissection can sometimes be required, for instance, when the truncus anterior is short.
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Approaching the pulmonary artery within a fused fissure (MP4 190504Â kb)
Division of the lingular arteries and of the lingular lymph node (MOV 203973Â kb)
Division of the anterior aspect of the fissure (MP4 43394Â kb)
Control of the posterior ascending arteries (MP4 16121Â kb)
Control of the superior pulmonary vein (MOV 9217Â kb)
Example of completion of a left upper lobectomy with the lobe elevated to expose the truncus anterior and the bronchus (MOV 195411Â kb)
Video (MOV 1330258 kb)
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Gossot, D. (2018). Left Upper Lobe. In: Atlas of Endoscopic Major Pulmonary Resections. Springer, Cham. https://doi.org/10.1007/978-3-319-55901-8_6
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DOI: https://doi.org/10.1007/978-3-319-55901-8_6
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Publisher Name: Springer, Cham
Print ISBN: 978-3-319-55900-1
Online ISBN: 978-3-319-55901-8
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