Transcervical Right and Left Upper Pulmonary Lobectomies

Abstract

In this chapter we present a new technique of transcervical right and left upper lobectomy with transcervical extended mediastinal lymphadenectomy (TEMLA) for stage I non-small cell lung cancer. The operation is performed through a collar incision, with elevation of the sternal manubrium with a mechanical sternal retractor. TEMLA and bilateral mediastinal lymph node excision are performed initially with intraoperative imprint cytology analysis of all nodes. In case of negative results of the study of all nodes, the mediastinal pleura is opened and the structures of the upper lobar hilum are dissected in the open fashion with standard surgical instruments and divided with the use of endostaplers. The operation is performed with the use of one port for insertion of the videothoracoscope.