Thoracoscopic Right Apicoposterior Segmentectomy

S2 and S1+2 segmentectomies are frequently indicated, as the location of a tumor or a nodule in S2 or at the border between S2 and S1 is not unusual. Preserving S3 rather than performing an upper lobectomy has two advantages: it spares respiratory function, and S3 is a large segment that occupies the pleural cavity and prevents reexpansion issues that can be encountered after an upper lobectomy, as illustrated in Video 1 and Figure 1.

The technique the authors describe is based on a thoracoscopic fissure-first approach whose rational and basics have been reported (1, 2). This technical description is based on an experience of 63 right S1+2segmentectomies out of a series of 375 thoracoscopic segmentectomies that have been performed at the authors' institution. Knowledge of anatomical landmarks and anatomical variations is a prerequisite to feeling secure during these procedures (3).

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