Minimally Invasive Complex Segmentectomies of the Right Upper Lobe: Anterior Segmentectomy, Apical Segmentectomy, and Posterior Segmentectomy

Abstract

Anatomic segmentectomy becomes an actual therapeutic option for the thoracic surgeon on lung cancer treatment. Mostly applied for early-stage lung cancer resections, its applications go further passing from localized benign disease and metastatic lung lesions. Due to the anatomic complexity and the vascular anatomic variations of the segments, It is usually more technically challenging than a standard lobectomy. This complexity is noted mainly in single-segment resections where there is a need to treat more than 1 intersegmental plane. The great anatomical variation and the high occurrence of lesions in the upper lobes make it important to study sublobar resections of the right upper lobe. Performing it with minimally invasive access requires a great knowledge of the technique to standardize the approach avoid pitfalls and optimize the procedure outcomes. This paper aims to describe the anatomic segmental resections of the right upper lobe performed by minimally invasive access, anticipating instructions for video thoracoscopic and robotic approaches.