Robotic upper division segmentectomy of the left upper lobe without turning the lung.

Abstract

The fissureless technique in lobectomy or the unidirectional dissection technique in segmentectomy is considered useful to avoid a postoperative prolonged air leak if a fissure is fused because it is not dissected. Another advantage of this technique is that it does not require repeated rotation of the lung to obtain a good surgical view, which may result in a shorter operating time. We believe that this technique is suitable for a robotic approach because we sometimes find it difficult to rotate the lung parenchyma in the limited rigid thoracic cavity when using the robotic approach. We demonstrate a robotic upper division segmentectomy of the left upper lobe with an explanation of the nuances of its performance. The console time was 74 minutes with minimal blood loss. The patient's postoperative course was uneventful. On the day of the operation, we removed the chest tube because we found no air leak. The patient was discharged on postoperative day (POD) 2. The final pathology report showed that a sufficient surgical margin was achieved. These good perioperative results indicate the feasibility of this technique.