Innovative segmentectomy to remove the posterior segment of the lower lobe (S¹⁰) of the lung

We describe our innovative technique for performing segmentectomy of the posterior segment of the lower lobe of the lung, being segment number 10 (S¹⁰). In segmentectomy of S¹⁰, it is difficult to identify A¹⁰ from the interlobar fissure because the pulmonary artery to S¹⁰ (A¹⁰) branches from A⁹⁺¹⁰ and runs dorsally and deeply into the lung tissue. Moreover, to reach S¹⁰ from the interlobar fissure, the lung tissue should be cut between S⁶ and S⁸, because S¹⁰ is not located beside the interlobar fissure. However, it is difficult to identify the boundary between the S⁶ and S⁸ without a route marker. To solve these difficulties, we divided S⁶ and S¹⁰ from each other at the beginning of the procedure, which enabled A¹⁰ to be identified easily from the dorsal side. Because S⁶ and S^8–10 should be divided in S¹⁰ segmentectomy at the end, the division between S⁶ and S^8–10 at the beginning of procedure is not only reasonable, but makes the procedure simple.