Pulmonary segmentectomy is proposed for treatment of early-stage non-small cell lung cancer with adequate surgical margin and lymph node dissection.
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2 However, it is a technically more challenging procedure than lobectomy by video-assisted thoracoscopic surgery (VATS). For some complex pulmonary segmentectomies, especially for a single basal segmentectomy, the exposure and identification of the bronchovascular structures that commonly variable and deeply located in the pulmonary parenchyma are both technical obstacles. Therefore, a proper surgical approach and a valid method of intraoperative identification for complex segmentectomy are the key points. Although VATS single and combined basal segmentectomy has been reported to be feasible through the interlobar fissure approach or an artificial intersegmental tunnel, it remains challenging particularly in case of incomplete fissure.
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4 Although 3D reconstruction based on radiological imaging can facilitate the identification of the hilar structures preoperatively, it remains difficult to identify intraoperatively without 3D navigation equipment, which only a few hospitals are equipped with. …
