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Left Upper Lobe

  • Dominique Gossot
Chapter

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.

Supplementary material

Video 6.1

Approaching the pulmonary artery within a fused fissure (MP4 190504 kb)

Video 6.2

Division of the lingular arteries and of the lingular lymph node (MOV 203973 kb)

Video 6.3

Division of the anterior aspect of the fissure (MP4 43394 kb)

Video 6.4

Control of the posterior ascending arteries (MP4 16121 kb)

Video 6.5

Control of the superior pulmonary vein (MOV 9217 kb)

Video 6.6

Example of completion of a left upper lobectomy with the lobe elevated to expose the truncus anterior and the bronchus (MOV 195411 kb)

Video (MOV 1330258 kb)

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Dominique Gossot
    • 1
  1. 1.IMM, Curie-Montsouris Thorax InstituteParisFrance

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