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3D-CT Images-Based Lung Segmentectomy Planning and Intraoperative Navigation
Port Placement and Instruments in Robotic Segmentectomy
Robotic Segmentectomy Using the Lung Base-Flip Approach
- Eguchi T.
- Hara D.
- Matsuoka S.
- Miura K.
- Hamanaka K.
- Shimizu K.
- et al.
- Video 1
A schematic demonstration of the lung base-flip approach. Video available at: https://www.jtcvs.org/article/S2666-2507(22)00424-2/fulltext.
- Video 2
A female patient in her 50s with bilateral lung metastases who underwent a 2-staged bilateral metastasectomy (left side followed by the right) is shown (the right-side surgery is shown in the Video 3). The surgical findings are shown on the right side of the screen, while corresponding 3D-CT images are shown on the left side. In the 3D-CT images, the green nodules represent the tumors. On the left side, we performed intraoperative tumor localization using radiofrequency identification technology and placed a marker via bronchoscopy.2,5The marker is shown as the purple point in the 3D-CT images. The patient’s postoperative course was uneventful. Pathological examination revealed a metastatic lung tumor of uterine origin with a negative surgical margin. The patient underwent adjuvant chemotherapy after the 2-stage lung metastasectomy. A robotic left S9b (the caudal subsegment of the lateral-basilar segment) subsegmentectomy was successfully completed with the following steps: (1) division of the lung ligaments, (2) dissection of the central intersegmental planes (S8-S9 and S9-S10) along with the corresponding intersegmental veins (V8 and V9, respectively), (3) hilar dissection with division of V9, B9b, and A9b, and (4) stapling of the peripheral intersegmental planes after systemic ICG administration. Video available at: https://www.jtcvs.org/article/S2666-2507(22)00424-2/fulltext.
- Video 3
A robotic right S10b (the caudal subsegment of the posterior-basilar segment) subsegmentectomy was successfully completed in the following manner: (1) division of the lung ligament, (2) dissection of the central intersegmental planes (S6-S10 and S7-S10) along with the corresponding intersegmental veins (V6 and V7b, respectively), (3) hilar dissection with division of V7b, B10b, and A10b, and (4) stapling of the peripheral intersegmental planes after systemic ICG administration. Video available at: https://www.jtcvs.org/article/S2666-2507(22)00424-2/fulltext.
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Disclosures: The authors reported no conflicts of interest.
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