Division of Thoracic Surgery, Tata Memorial Hospital, Mumbai, India.
Multimed Man Cardiothorac Surg. 2021 Oct 7;2021. doi: 10.1510/mmcts.2021.057.
This video tutorial describes a left lower lobectomy performed by the uniportal approach. A single 2-cm incision in the lateral chest wall is used as the utility port. The procedure begins with division of the inferior pulmonary ligament and isolation of the inferior pulmonary vein. This patient has densely adherent interlobar nodes, which are then dissected to demonstrate the interlobar pulmonary artery. Then we proceed to divide the anterior part of the fissure after identifying and safeguarding the lingular branches of the pulmonary artery. This step is followed by the division of the posterior part of the fissure after identification of the posterior branches of the pulmonary artery to the upper lobe. Then we identify the basilar trunk and divide it using endostaplers. Other branches of the interlobar artery are clearly identified, and the apicobasal artery is taken separately. This is followed by division of the inferior pulmonary vein and a systematic mediastinal nodal dissection.
本视频教程介绍了经单孔入路行左下肺叶切除术。在侧胸壁开一个 2cm 的小切口作为操作孔。手术首先游离下肺韧带并离断下肺静脉。此患者有致密粘连的肺叶间淋巴结，然后将其解剖以显露肺叶间肺动脉。在识别并保护肺动脉舌段分支后，我们先处理段间裂的前部分。然后在识别上叶的肺动脉后支后处理段间裂的后部分。接着识别基底干并使用切割缝合器离断。其他叶间动脉分支清晰可见，尖后动脉单独处理。然后离断下肺静脉并进行系统纵隔淋巴结清扫。
