title: Hybrid video-assisted thoracic surgery basilar (S9-10) segmentectomy.
abstract: We perform segmentectomy for patients with cT1N0 non-small cell lung cancer (NSCLC) of 2 cm or less, even in good-risk patients. Hilar dissection and intersegmental dissection are performed by using mainly direct visualization through the access thoracotomy, which is called hybrid video-assisted thoracic surgery (VATS). Identification of the intersegmental plane is performed by selective jet ventilation under bronchofiberscopy. With this method, the segment to be removed can be inflated, while the segments to be preserved are kept deflated. When the intersegmental plane is being divided by electrocautery, direct visualization during the hybrid VATS approach is extremely important, because a 3-dimensional understanding of the pulmonary anatomy is crucial to avoid ambiguous procedures.
authors.affiliation: Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. ymiyata@hiroshima-u.ac.jp
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyata
authors.forename: Morihito
authors.initials: M
authors.lastname: Okada
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008168:Lung / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D017792:Surgical Stapling; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome