Uniport video-assisted segmentectomy of left upper lung by fluorescence thoracoscopy and lymph node dissection
LIU Ning
LIN Yong
LI Yuanhang
CHEN Xinfu
LI Yimin
Abstract：The patient underwent general anesthesia with double lumen endotracheal intubation during the operation.The healthy side was placed in the prone jackknife position,and the healthy side was mechanically ventilated.Using a 3.0 cm incision in the fourth intercostal space of the axillary line as the operating hole and a 1 cm incision in the seventh intercostal space as the observation hole,the Opdiman thoracoscopic fluorescence imaging system was used.Based on the patient's preoperative thin-layer CT data,the current surgical plan was implemented to accurately identify and isolate the target segment veins,arteries and bronchi,focusing on protecting the inter-segment veins.Afterwards,the thoracoscope was switched to fluorescence mode.The circulating nurse dissolved 25 mg indocyanine green in 10 mL of physiological saline,of which 2 mL(equivalent to 5 mg indocyanine green)was injected through the peripheral vein.Indocyanine green combined with plasma proteins in the blood,emitting fluorescence with a wavelength of(780-805)nm.The fluorescence lamp specially designed for thoracoscopy[(700-900)nm]was used,effectively identifying this wavelength and displaying a green fluorescent staining plane,which was the interface between segments(the target segment tissue couldnot be stained in fluorescence mode due to the inability of fluorescent agents to enter after vascular detachment).The interface was marked,the segment gate was freed with energy instruments,the plane between segments was cut using a lung cutting stapler,and the resection of the intrinsic segment of the left upper lung was completed.Based on the intraoperative frozen pathological results,the pulmonary hilum and mediastinal lymph nodes were sampled and cleaned.After surgery,two thoracic tubes were placed through the operating hole and observation hole.
Keywords：non-small cell lung cancerlung segmentectomyfluorescent thoracoscopy
Publication Date：2024-10-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 13-15 )