Thoracoscopic Bronchial Ligation In Situ Performed In Lobectomy
Jinglong Li, Dazhi Pang, Taiyang Liuru, Qiao Liu, Jitian Zhang, Jianguo Lu, Guangqiang Shao, Zhihai Liu, Jinjin Yan, Yanan Liang, Minghui Zhu.
The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
BACKGROUND: This surgical video focuses on the feasibility of the bronchial ligation method during thoracoscopic lobectomy.METHODS: The patient was a 42-year-old female who was admitted to the hospital due to the discovery of lung nodules for 1 year. No respiratory symptoms appeared. Chest CT showed ground glass nodules in the dorsal and posterior basal segments of the lower lobe of the right lung, measuring approximately 9*10 mm and 8*7 mm, respectively. PET/CT showed early lung cancer possible. The patient was a non-smoker, denied a family history of lung cancer, and had no history of tuberculosis or chronic obstructive pulmonary disease. The preoperative diagnosis was ground glass nodules in the lower lobe of the right lung. The patient underwent a single-port thoracoscopy with a 4th intercostal incision of approximately 3 cm in length. Thoracoscopic wedge resection of nodules in the dorsal and posterior basal segments of the right lower lung lobe. Both nodules were reported as invasive adenocarcinoma by sending frozen pathology, followed by right lower lung lobectomy and lymph node dissection. RESULTS: The operative time was 196 minutes and the bleeding volume was 50 ml. Hospitalization was 8 days and the hospital cost was about $5000. Postoperative pathology was both invasive adenocarcinomas, and the postoperative staging was pT1aN0M0 IA1.CONCLUSIONS: Bronchial ligation in situ is feasible in thoracoscopic lobectomy and can reduce the application of cutting sutures reducing the hospitalization cost. The application of knot-free ligatures in the future may shorten the operative time. 
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