Video-assisted left lower lobectomy with intrapericardial pulmonary vein isolation

2020 ◽  
Keyword(s):  
Pulmonary Vein ◽  
Lower Lobe ◽  
Radical Resection ◽  
Hemodynamic Instability ◽  
Uneventful Recovery ◽  
Thoracoscopic Approach ◽  
Video Tutorial ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy ◽  
Operative Planning

The thoracoscopic approach to lobectomy is now the gold standard in cases of pulmonary malignancies because it is associated with a significant reduction in both postoperative hospital stay and pain. Even in cases of complex resection, as in the case reported here, the procedure can be performed safely after careful pre-operative planning. This video tutorial describes our technique for the intrapericardial isolation of the left inferior pulmonary vein in a patient affected by a left lower lobe metastasis from a colonic carcinoma. The lesion was retracting the inferior vein to such an extent that an intrapericardial approach was required in order to obtain a radical resection. The operation was carried out using a 3-port technique to allow for safe and unhindered manipulation of the hilar structures and the parenchyma. The pericardial sac was easily opened and the feasibility of the procedure was readily confirmed. The patient made an uneventful recovery; specifically, we did not record any arrhythmia or hemodynamic instability. She was discharged home on the 4th postoperative day.

VATS right basal segmentectomy for NSCLC in a patient with systemic sclerosis

2020 ◽  
Keyword(s):  
Systemic Sclerosis ◽  
Early Stage ◽  
Lower Lobe ◽  
Radical Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Thoracoscopic Approach ◽  
Video Tutorial ◽  
Intersegmental Plane ◽  
The Right

In recent decades, the thoracoscopic approach has been accepted as the gold standard to treat early stage non-small-cell lung cancer because it reduces postoperative pain and results in a shorter hospital stay. More recently, several techniques for performing sublobar resection have been reported that achieve a radical resection while sparing as much parenchyma as possible. This video tutorial illustrates our technique for resecting the basal segments of the right lower lobe in a patient presenting with an adenocarcinoma in the right lower lobe. The patient also had systemic sclerosis, which led to pulmonary hypertension and fibrosis. Therefore, it was important to limit the parenchymal resection to save the apical segment of the lower lobe so as not to exacerbate the underlying conditions. The vascular and bronchial structures are readily identifiable, and the intersegmental plane can be easily accessed by clamping the associated bronchus while inflating the lung.

Uniportal VATS left lower lobectomy: Fissure first technique

2021 ◽  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Vein ◽  
Chest Wall ◽  
Anterior Part ◽  
Posterior Part ◽  
Video Tutorial ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy ◽  
Nodal Dissection ◽  
Lateral Chest

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.

scholarly journals Metastatic renal cell carcinoma extending to the left atrium through the inferior pulmonary vein

2021 ◽  
Author(s):  
Alan G Dawson ◽  
Cathy J Richards ◽  
Leonidas Hadjinikolaou ◽  
Apostolos Nakas
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Left Atrium ◽  
Pulmonary Vein ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Pulmonary Veins ◽  
Lower Lobe ◽  
Inferior Pulmonary Vein ◽  
The Right

Abstract Metastatic renal cell carcinoma with involvement through the pulmonary veins to the left atrium is very rare. We report the case of a 70-year-old male with metastatic renal cell carcinoma to the right lower lobe of the lung abutting the inferior pulmonary vein with extension to the left atrium without pre-operative evidence. Surgical resection was achieved through a posterolateral thoracotomy. Lung masses that abut the pulmonary veins should prompt further investigation with a pre-operative transoesophageal echocardiogram to minimize unexpected intraoperative findings.

scholarly journals Acute limb ischemia by a pulmonary vein stump thrombus after left lower lobectomy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuri Fujimoto ◽  
Ryosuke Hamachi ◽  
Yoshimasa Motoyama ◽  
Etsuko Kanna ◽  
Masako Murakami ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Thrombus Formation ◽  
Limb Ischemia ◽  
Artery Occlusion ◽  
Common Symptom ◽  
Acute Limb Ischemia ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy ◽  
Enhanced Computed Tomography ◽  
Pulmonary Vein Stump

Abstract Background Cases of systemic thromboembolism due to thrombus formation in the pulmonary vein stump after lobectomy have been reported recently. Cerebral infarction after left upper lobectomy is a common symptom in these cases. We encountered a rare case of acute limb ischemia caused by a thrombus formed in the left inferior pulmonary vein stump after left lower lobectomy. Case presentation A 62-year-old man underwent video-assisted left lower lobectomy under general anesthesia with epidural anesthesia. On postoperative day 2, he suddenly developed pain in the left calf. Contrast-enhanced computed tomography showed left popliteal artery occlusion and thrombus formation in the left inferior pulmonary vein stump. Anticoagulant therapy was started immediately, and emergent endovascular thrombectomy was performed. The patient recovered without complications. Conclusions Left lower lobectomy can cause thrombus formation in the pulmonary vein stump, leading to systemic thromboembolism. Early detection and treatment are the keys to minimize complications.

Uniportal thoracoscopic apical (S1) segmentectomy of the right upper lobe via an anterior approach

2021 ◽  
Keyword(s):  
Anterior Approach ◽  
Single Port ◽  
Lower Lobe ◽  
Thoracoscopic Approach ◽  
Anterior Axillary Line ◽  
Single Port Access ◽  
Video Tutorial ◽  
Port Access ◽  
Intersegmental Plane ◽  
The Right

An apical (S1) segmentectomy of the right upper lobe is considered one of the most challenging procedures among the uncommon pulmonary segmentectomies. However, we consider that the uniportal thoracoscopic approach, for which the single port access is located at the 4th intercostal space of the anterior axillary line, makes this challenging operation easier because we can recognize any intrathoracic vessels and bronchi that should be divided just under the incision. Moreover, it is easy to insert a stapler to divide an intersegmental plane between S1 and the other segments because of the good surgical view provided by this approach. In this video tutorial, we describe the successful results of a patient undergoing uniportal thoracoscopic S1 segmentectomy of the right lower lobe and explain the nuances of performing it.

Anatomy of inferior pulmonary vein should be clarified in lower lobectomy

1998 ◽  
Vol 66 (5) ◽  
pp. 1799-1800 ◽  
Author(s):  
Satoru Sugimoto ◽  
Osamu Izumiyama ◽  
Akio Yamashita ◽  
Masahito Baba ◽  
Tadashi Hasegawa
Keyword(s):  
Pulmonary Vein ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy

scholarly journals En bloc transdiaphragmatic lung resection for locally advanced hepatocellular carcinoma: a case report

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Kit-fai Lee ◽  
Randolph H L Wong ◽  
Howard H W Leung ◽  
Eugene Y J Lo ◽  
Charing C N Chong ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Locally Advanced ◽  
Left Lung ◽  
Lower Lobe ◽  
Uneventful Recovery ◽  
Advanced Hepatocellular Carcinoma ◽  
Right Hepatectomy ◽  
En Bloc ◽  
Liver Recurrence ◽  
Lung Base

Abstract A 56-year-old man presented with an 11-cm hepatocellular carcinoma (HCC) at segment 7 of liver. To induce left liver hypertrophy, a sequential transarterial chemoembolization (TACE) and portal vein embolization before right hepatectomy were adopted. However, the tumor further increased in size despite TACE and invaded through the diaphragm to the right lung base. Anterior approach right hepatectomy with en bloc wedge resection of the involved right lower lobe of lung by endovascular staplers via transdiaphragmatic approach was performed. The diaphragmatic defect was closed with Goretex mesh. Patient made an uneventful recovery. Pathology confirmed a 12.5 cm poorly differentiated HCC invading through diaphragm to lung. During follow-up, patient developed a 6 cm recurrence at left lung base 17 months after surgery for which he received sorafenib therapy. However, the lung mass further increased in size with new liver recurrence at segment 3 despite treatment. He succumbed 2 years and 3 months after surgery.

Anatomic predictors of late right inferior pulmonary vein reconnection in the setting of second‐generation cryoballoon ablation

2019 ◽  
Vol 30 (11) ◽  
pp. 2294-2301
Author(s):  
Muryo Terasawa ◽  
Gian‐Battista Chierchia ◽  
Ken Takarada ◽  
Alessandro Rizzo ◽  
Riccardo Maj ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Second Generation ◽  
Cryoballoon Ablation ◽  
Inferior Pulmonary Vein ◽  
Pulmonary Vein Reconnection

Application of pelvic-style docking in robotic surgery for lower-middle mediastinal tumors

2020 ◽  
pp. 021849232098488
Author(s):  
Shota Mitsuboshi ◽  
Hideyuki Maeda ◽  
Masato Kanzaki
Keyword(s):  
Robotic Surgery ◽  
Pulmonary Vein ◽  
Target Lesion ◽  
Field Of View ◽  
Robotic Arm ◽  
Easy Access ◽  
Port Placement ◽  
Mediastinal Tumors ◽  
Inferior Pulmonary Vein ◽  
Camera Port

For robotic surgery, in a field of view looking upwards, the target lesion to be operated on should lie between the camera port and the robot. The ports are placed at the bottom of the chest wall. If the tumor is located below the inferior pulmonary vein, it is necessary to devise alternative port placement and robot docking methods. In 4 patients who had lower middle mediastinal tumors, the “Pelvic” setting on the visual pad of the patient cart was used, which allows easy access for lower middle mediastinal manipulation and results in minimal issues with robotic arm collisions.

scholarly journals A sneaky vertebra during a right inferior pulmonary vein laser ablation

2021 ◽  
Author(s):  
Hideyuki Aoki ◽  
Yuichi Hori ◽  
Reiko Fukuda ◽  
Shiro Nakahara
Keyword(s):  
Laser Ablation ◽  
Pulmonary Vein ◽  
Inferior Pulmonary Vein
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