Atlas of endoscopic major pulmonary resections (eBook)

Title Page 3
Copyright Page 4
Warning 5
Acknowledgments 6
Abbreviations and symbols used in this atlas 7
Table of Contents 8
Foreword 9
General considerations 10
Introduction 11
Bibliography 13
General aspects 13
Long-term results 13
Comparative studies and trials 13
Benign conditions 14
Clinical and immunological impact 14
Training and teaching 15
Technical aspects 15
Segmentectomies 15
Chapter I Tips and tricks 17
Ergonomics and operating room setting 17
Trocars 20
Enhancing vision and video-imaging 21
Obtaining pathological diagnosis 22
Exposure and lung retraction 22
Fissures 22
Exposure of bronchial and vascular elements 23
Vascular control 23
Vascular injuries 24
Intersegmental plane and division of the parenchyma 26
Specimen retrieval 27
Bibliography 28
General aspects 28
Instruments 28
Haemostatic devices 28
Technical tricks 28
Chapter II Endoscopic mediastinal lymph node dissection 30
Definition 30
Specific issues related to the endoscopic approach 30
Technique 31
Stations 11 and 12 31
Station 10 32
Stations 9 and 8 32
Station 7 (left-side approach) 32
Stations 6 and 5 34
Station 7 (right-side approach) 34
Stations 4R and 2R 37
Bibliography 39
General aspects 39
Thoracoscopic lymphadenectomy 39
Lobectomies 41
Chapter III Right upper lobe 42
Anatomical landmarks (Fig. 1) 43
Technique 1: anterior approach 45
1. Hilum 45
2. Fissure and posterior artery 47
3. Bronchus 49
4. Division of the minor fissure 50
5. Division of the pulmonary ligament 51
6. Securing the middle lobe 51
Technique 2: posterior approach 52
1. Fissure and posterior artery 52
2. Bronchus 53
3. Truncus anterior 54
Chapter IV Middle lobe 55
Anatomical landmarks (Fig. 1) 56
Technique 58
1. Fissure and lateral segmental artery 58
2. Fissure and vein 59
3. Bronchus 61
4. Medial segmental artery 61
5. Transverse fissure 62
Chapter V Right lower lobe 64
Anatomical landmarks (Fig. 1) 65
Technique 67
1. Fissure and arteries 67
2. Inferior pulmonary vein 70
3. Bronchus 71
Chapter VI Left upper lobe 73
Anatomical landmarks (Fig. 1) 74
Technique 76
Posterior approach 76
1. Fissure and lingular artery 76
2. Posterior arteries 79
3. Truncus anterior 81
4. Superior vein 83
5. Upper lobe bronchus 84
6. Pulmonary ligament 85
Anterior approach 87
1. Vein 87
2. Truncus anterior 87
3. Next steps 88
Chapter VII Left lower lobe 89
Anatomical landmarks (Fig. 1) 90
Technique 93
1. Fissure and arteries 93
2. Vein 98
3. Bronchus 99
Segmentectomies 101
Chapter VIII Right upper lobe: apicoposterior segments 102
Anatomical landmarks (Fig. 1) 103
Technique 105
1. Fissure and ascending posterior artery 105
2. Segmental bronchi 106
3. Apical artery 109
4. Apical vein 110
5. Division of the parenchyma 111
Chapter IX Right lower lobe: superior segment 113
Anatomical landmarks (Fig. 1) 114
Technique 116
1. Fissure and artery 116
2. Bronchus 118
3. Vein 119
4. Parenchymal division 120
Chapter X Right lower lobe: basal segments 121
Anatomical landmarks (Fig. 1) 122
Technique 124
1. Fissure and artery 124
2. Bronchus 126
3. Vein 127
4. Division of the parenchyma 129
Chapter XI Left upper lobe: superior segments 132
Anatomical landmarks (Fig. 1) 133
Technique 135
a. Upper division 135
1. Veins 135
2. Truncus anterior 136
3. Fissure and posterior arteries 137
4. Bronchi 139
5. Parenchyma 140
b. Apicoposterior segmentectomy 141
1. Fissure and arteries 141
2. Vein 141
3. Bronchi 142
Chapter XII Left upper lobe: lingula 143
Anatomical landmarks (Fig. 1) 144
Technique 146
1. Fissure and artery 146
2. Bronchus 147
3. Vein 148
4. Division of the parenchyma 149
Chapter XIII Left lower lobe: superior segment 150
Anatomical landmarks (Fig. 1) 151
Technique 153
1. Fissure and artery 153
2. Bronchus 155
3. Vein 155
4. Parenchymal division 157
Chapter XIV Left lower lobe: basal segments 159
Anatomical landmarks (Fig. 1) 160
Technique 162
1. Fissure and artery 162
2. Bronchus 164
3. Vein 165
4. Division of the parenchyma 167