VATS segmentectomy: past, present, and future

General Thoracic and Cardiovascular Surgery volume 66, pages81–90(2018)Cite this article

Abstract

Video-assisted thoracoscopic surgery (VATS) has gradually been implemented in thoracic surgery, and the VATS approach has now been extended to technically challenging procedures, such as segmentectomy. The definition of VATS segmentectomy is changing over time, and the repertoire of segmentectomy is getting wider with increasing reports on atypical segmentectomy. VATS segmentectomy bears surgical, oncological, and technical advantages; however, there are still areas of controversy, particularly regarding oncological outcomes. The indication of VATS segmentectomy is diverse and is used for treating lung cancer, metastatic lung tumors, or a variety of nonmalignant diseases. It is particularly valuable for the lung-sparing resection of deeply located small nodules or repeated surgery for multiple lung lesions. VATS segmentectomy requires a thorough analysis of segmental anatomy and a tailored preoperative planning with the assessment of surgical margins. Technical challenges include intraoperative navigation, methods to identify and dissect the intersegmental plane, and the prevention of air leakage. This review will discuss the present state of VATS segmentectomy, with a focus on past studies, current indications and techniques, and future view.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

Figure adapted from Shimizu et al. [70]

Fig. 3

References

  1. 1.

    Masuda M, Kuwano H, Okumura M, Arai H, Endo S, Doki Y, et al. Thoracic and cardiovascular surgery in japan during 2013: annual report by the japanese association for thoracic surgery. Gen Thorac Cardiovasc Surg. 2015;63:670–701.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Yim AP. VATS major pulmonary resection revisited–controversies, techniques, and results. Ann Thorac Surg. 2002;74:615–23.

    Article  PubMed  Google Scholar 

  3. 3.

    Rocco G, Internullo E, Cassivi SD, Van Raemdonck D, Ferguson MK. The variability of practice in minimally invasive thoracic surgery for pulmonary resections. Thorac Surg Clin. 2008;18:235–47.

    Article  PubMed  Google Scholar 

  4. 4.

    Okada M, Sakamoto T, Yuki T, Mimura T, Miyoshi K, Tsubota N. Hybrid surgical approach of video-assisted minithoracotomy for lung cancer: significance of direct visualization on quality of surgery. Chest. 2005;128:2696–701.

    Article  PubMed  Google Scholar 

  5. 5.

    Ceppa DP, Balderson S, D’Amico TA. Technique of thoracoscopic basilar segmentectomy. Semin Thorac Cardiovasc Surg. 2011;23:64–6.

    Article  PubMed  Google Scholar 

  6. 6.

    Nomori H, Okada M. Illustrated anatomical segmentectomy for lung cancer. Tokyo: Springer; 2012.

    Google Scholar 

  7. 7.

    Endoh M, Oizumi H, Kato H, Suzuki J, Watarai H, Masaoka T, Sadahiro M. Posterior approach to thoracoscopic pulmonary segmentectomy of the dorsal basal segment: a single-institute retrospective review. J Thorac Cardiovasc Surg. 2017;154(4):1432–9.

  8. 8.

    Sato M, Murayama T, Nakajima J. Techniques of stapler-based navigational thoracoscopic segmentectomy using virtual assisted lung mapping (VAL-MAP). J Thorac Dis. 2016;8:S716–30.

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Tsubokawa N, Harada H, Takenaka C, Misumi K, Yamashita Y. Comparison of postoperative pain after different thoracic surgery approaches as measured by electrical stimulation. Thorac Cardiovasc Surg. 2015;63:519–25.

    Article  PubMed  Google Scholar 

  10. 10.

    Ghaly G, Kamel M, Nasar A, Paul S, Lee PC, Port JL, et al. Video-Assisted thoracoscopic surgery is a safe and effective alternative to thoracotomy for anatomical segmentectomy in patients with clinical stage I non-small cell lung cancer. Ann Thorac Surg. 2016;101:465–72.

    Article  PubMed  Google Scholar 

  11. 11.

    Lex JR, Naidu B. In patients with resectable non-small-cell lung cancer, is video-assisted thoracoscopic segmentectomy an appropriate alternative to video-assisted thoracoscopic lobectomy? Interact Cardiovasc Thorac Surg. 2016;23:826–31.

    Article  PubMed  Google Scholar 

  12. 12.

    Martin-Ucar AE, Nakas A, Pilling JE, West KJ, Waller DA. A case-matched study of anatomical segmentectomy versus lobectomy for stage I lung cancer in high-risk patients. Eur J Cardiothorac Surg. 2005;27:675–9.

    Article  PubMed  Google Scholar 

  13. 13.

    Rizk NP, Ghanie A, Hsu M, Bains MS, Downey RJ, Sarkaria IS, et al. A prospective trial comparing pain and quality of life measures after anatomic lung resection using thoracoscopy or thoracotomy. Ann Thorac Surg. 2014;98:1160–6.

    Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Deng B, Cassivi SD, de Andrade M, Nichols FC, Trastek VF, Wang Y, et al. Clinical outcomes and changes in lung function after segmentectomy versus lobectomy for lung cancer cases. J Thorac Cardiovasc Surg. 2014;148:1186–92.e3.

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Comparison of morbidity of pulmonary segmentectomy and lobectomy: Initial results of a phase III randomized trial of lobectomy versus segmentectomy for small (2 cm or less) peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). http://aats.org/aatsimis/AATS/Meetings/Active_Meetings/Centennial/Preliminary%20Program/Abstracts/21.aspx. Accessed 19 Nov 2017.

  16. 16.

    Khullar OV, Liu Y, Gillespie T, Higgins KA, Ramalingam S, Lipscomb J, Fernandez FG. Survival after sublobar resection versus lobectomy for clinical stage IA lung cancer: an analysis from the national cancer data base. J Thorac Oncol. 2015;10:1625–33.

    Article  PubMed  Google Scholar 

  17. 17.

    Kent M, Landreneau R, Mandrekar S, Hillman S, Nichols F, Jones D, et al. Segmentectomy versus wedge resection for non-small cell lung cancer in high-risk operable patients. Ann Thorac Surg. 2013;96:1747–54.

    Article  PubMed  Google Scholar 

  18. 18.

    Nakamura H, Taniguchi Y, Miwa K, Adachi Y, Fujioka S, Haruki T, et al. Comparison of the surgical outcomes of thoracoscopic lobectomy, segmentectomy, and wedge resection for clinical stage I non-small cell lung cancer. Thorac Cardiovasc Surg. 2011;59:137–41.

    CAS  Article  PubMed  Google Scholar 

  19. 19.

    Ramos R, Girard P, Masuet C, Validire P, Gossot D. Mediastinal lymph node dissection in early-stage non-small cell lung cancer: totally thoracoscopic vs thoracotomy. Eur J Cardiothorac Surg. 2012;41:1342–8.

    Article  PubMed  Google Scholar 

  20. 20.

    Zhou H, Tapias LF, Gaissert HA, Muniappan A, Wright CD, Wain JC, et al. Lymph node assessment and impact on survival in video-assisted thoracoscopic lobectomy or segmentectomy. Ann Thorac Surg. 2015;100:910–6.

    Article  PubMed  Google Scholar 

  21. 21.

    Boffa DJ, Kosinski AS, Paul S, Mitchell JD, Onaitis M. Lymph node evaluation by open or video-assisted approaches in 11,500 anatomic lung cancer resections. Ann Thorac Surg. 2012;94:347–53.

    Article  PubMed  Google Scholar 

  22. 22.

    Shapiro M, Weiser TS, Wisnivesky JP, Chin C, Arustamyan M, Swanson SJ. Thoracoscopic segmentectomy compares favorably with thoracoscopic lobectomy for patients with small stage I lung cancer. J Thorac Cardiovasc Surg. 2009;137:1388–93.

    Article  PubMed  Google Scholar 

  23. 23.

    Misaki N, Chang SS, Gotoh M, Yamamoto Y, Satoh K, Yokomise H. A novel method for determining adjacent lung segments with infrared thoracoscopy. J Thorac Cardiovasc Surg. 2009;138:613–8.

    Article  PubMed  Google Scholar 

  24. 24.

    Shimizu K, Nakazawa S, Nagashima T, Kuwano H, Mogi A. 3D-CT anatomy for VATS segmentectomy. J Vis Surg. 2017;3:88.

    Article  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Wang BY, Liu CC, Shih CS. Short-term results of thoracoscopic lobectomy and segmentectomy for lung cancer in koo foundation sun yat-sen cancer center. J Thorac Dis. 2010;2:64–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Gossot D, Zaimi R, Fournel L, Grigoroiu M, Brian E, Neveu C. Totally thoracoscopic pulmonary anatomic segmentectomies: technical considerations. J Thorac Dis. 2013;5(Suppl 3):S200–6.

    PubMed  PubMed Central  Google Scholar 

  27. 27.

    Wang BY, Tu CC, Liu CY, Shih CS, Liu CC. Single-incision thoracoscopic lobectomy and segmentectomy with radical lymph node dissection. Ann Thorac Surg. 2013;96:977–82.

    Article  PubMed  Google Scholar 

  28. 28.

    Han KN, Kim HK, Lee HJ, Choi YH. Single-port video-assisted thoracoscopic pulmonary segmentectomy: a report on 30 cases†. Eur J Cardiothorac Surg. 2016;49(Suppl 1):i42–7.

    PubMed  Google Scholar 

  29. 29.

    Hirai K, Takeuchi S, Usuda J. Single-port video-assisted thoracic surgery for early lung cancer: initial experience in japan. J Thorac Dis. 2016;8:S344–50.

    PubMed  PubMed Central  Google Scholar 

  30. 30.

    Kato H, Oizumi H, Suzuki J, Hamada A, Watarai H, Sadahiro M. Thoracoscopic anatomical lung segmentectomy using 3D computed tomography simulation without tumour markings for non-palpable and non-visualized small lung nodules†. Interact Cardiovasc Thorac Surg. 2017;25:434–41.

    Article  PubMed  Google Scholar 

  31. 31.

    Witte B, Stenz C, Vahl CF, Huertgen M. Comparative intention-to-treat analysis of the video-assisted thoracoscopic surgery approach to pulmonary segmentectomy for lung carcinoma‡. Interact Cardiovasc Thorac Surg. 2015;21:276–83.

    Article  PubMed  Google Scholar 

  32. 32.

    Leshnower BG, Miller DL, Fernandez FG, Pickens A, Force SD. Video-assisted thoracoscopic surgery segmentectomy: a safe and effective procedure. Ann Thorac Surg. 2010;89:1571–6.

    Article  PubMed  Google Scholar 

  33. 33.

    Yamashita S, Tokuishi K, Anami K, Moroga T, Miyawaki M, Chujo M, et al. Thoracoscopic segmentectomy for T1 classification of non-small cell lung cancer: a single center experience. Eur J Cardiothorac Surg. 2012;42:83–8.

    Article  PubMed  Google Scholar 

  34. 34.

    Hwang Y, Kang CH, Kim HS, Jeon JH, Park IK, Kim YT. Comparison of thoracoscopic segmentectomy and thoracoscopic lobectomy on the patients with non-small cell lung cancer: a propensity score matching study. Eur J Cardiothorac Surg. 2015;48:273–8.

    Article  PubMed  Google Scholar 

  35. 35.

    Lin Y, Zheng W, Zhu Y, Guo Z, Zheng B, Chen C. Comparison of treatment outcomes between single-port video-assisted thoracoscopic anatomic segmentectomy and lobectomy for non-small cell lung cancer of early-stage: a retrospective observational study. J Thorac Dis. 2016;8:1290–6.

    Article  PubMed  PubMed Central  Google Scholar 

  36. 36.

    Cheng K, Zheng B, Zhang S, Zheng W, Guo Z, Zhu Y, Chen C. Feasibility and learning curve of uniportal video-assisted thoracoscopic segmentectomy. J Thorac Dis. 2016;8:S229–34.

    Article  PubMed  PubMed Central  Google Scholar 

  37. 37.

    Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung cancer study group. Ann Thorac Surg. 1995;60:615–22.

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Wolf AS, Richards WG, Jaklitsch MT, Gill R, Chirieac LR, Colson YL, et al. Lobectomy versus sublobar resection for small (2 cm or less) non-small cell lung cancers. Ann Thorac Surg. 2011;92:1819–23.

    Article  PubMed  Google Scholar 

  39. 39.

    Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11:39–51.

    Article  PubMed  Google Scholar 

  40. 40.

    Travis WD, Asamura H, Bankier AA, Beasley MB, Detterbeck F, Flieder DB, et al. The IASLC lung cancer staging project: proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2016;11:1204–23.

    Article  PubMed  Google Scholar 

  41. 41.

    Watanabe A, Ohori S, Nakashima S, Mawatari T, Inoue N, Kurimoto Y, Higami T. Feasibility of video-assisted thoracoscopic surgery segmentectomy for selected peripheral lung carcinomas. Eur J Cardiothorac Surg. 2009;35:775–80.

    Article  PubMed  Google Scholar 

  42. 42.

    Schuchert MJ, Pettiford BL, Pennathur A, Abbas G, Awais O, Close J, et al. Anatomic segmentectomy for stage I non-small-cell lung cancer: comparison of video-assisted thoracic surgery versus open approach. J Thorac Cardiovasc Surg. 2009;138:1318–25.e1.

    Article  PubMed  Google Scholar 

  43. 43.

    Sugi K, Kobayashi S, Sudou M, Sakano H, Matsuda E, Okabe K. Long-term prognosis of video-assisted limited surgery for early lung cancer. Eur J Cardiothorac Surg. 2010;37:456–60.

    PubMed  Google Scholar 

  44. 44.

    Witte B, Wolf M, Hillebrand H, Huertgen M. Complete video-assisted thoracoscopic surgery anatomic segmentectomy for clinical stage I lung carcinoma—technique and feasibility. Interact Cardiovasc Thorac Surg. 2011;13:148–52.

    Article  PubMed  Google Scholar 

  45. 45.

    Zhong C, Fang W, Mao T, Yao F, Chen W, Hu D. Comparison of thoracoscopic segmentectomy and thoracoscopic lobectomy for small-sized stage IA lung cancer. Ann Thorac Surg. 2012;94:362–7.

    Article  PubMed  Google Scholar 

  46. 46.

    Tsutani Y, Miyata Y, Nakayama H, Okumura S, Adachi S, Yoshimura M, Okada M. Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage IA lung adenocarcinoma: wedge resection or segmentectomy. Chest. 2014;145:66–71.

    Article  PubMed  Google Scholar 

  47. 47.

    Smith CB, Kale M, Mhango G, Neugut AI, Hershman DL, Mandeli JP, Wisnivesky JP. Comparative outcomes of elderly stage I lung cancer patients treated with segmentectomy via video-assisted thoracoscopic surgery versus open resection. J Thorac Oncol. 2014;9:383–9.

    Article  PubMed  Google Scholar 

  48. 48.

    Mun M, Kohno T. Efficacy of thoracoscopic resection for multifocal bronchioloalveolar carcinoma showing pure ground-glass opacities of 20 mm or less in diameter. J Thorac Cardiovasc Surg. 2007;134:877–82.

    Article  PubMed  Google Scholar 

  49. 49.

    Zhang Y, Sun Y, Wang R, Ye T, Zhang Y, Chen H. Meta-analysis of lobectomy, segmentectomy, and wedge resection for stage I non-small cell lung cancer. J Surg Oncol. 2015;111:334–40.

    Article  PubMed  Google Scholar 

  50. 50.

    Nakamura K, Saji H, Nakajima R, Okada M, Asamura H, Shibata T, et al. A phase III randomized trial of lobectomy versus limited resection for small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol. 2010;40:271–4.

    Article  PubMed  Google Scholar 

  51. 51.

    Higashiyama M, Tokunaga T, Nakagiri T, Ishida D, Kuno H, Okami J. Pulmonary metastasectomy: outcomes and issues according to the type of surgical resection. Gen Thorac Cardiovasc Surg. 2015;63:320–30.

    Article  PubMed  Google Scholar 

  52. 52.

    Yamada S, Inoue Y, Suga A, Iwazaki M. Planned pulmonary resection for metastatic pulmonary tumor with video-assisted thoracoscopic surgery using multidetector row angiography. Gen Thorac Cardiovasc Surg. 2011;59:25–9.

    Article  PubMed  Google Scholar 

  53. 53.

    Lo Faso F, Solaini L, Lembo R, Bagioni P, Zago S, Soliani P, Pascotto RD. Thoracoscopic lung metastasectomies: a 10-year, single-center experience. Surg Endosc. 2013;27:1938–44.

    Article  PubMed  PubMed Central  Google Scholar 

  54. 54.

    Shiono S, Okumura T, Boku N, Hishida T, Ohde Y, Sakao Y, et al. Outcomes of segmentectomy and wedge resection for pulmonary metastases from colorectal cancer. Eur J Cardiothorac Surg. 2016;51:504–10.

    Google Scholar 

  55. 55.

    Hernández J, Molins L, Fibla JJ, Heras F, Embún R, Rivas JJ. Grupo Español de Metástasis Pulmonares de Carcinoma Colo-Rectal (GECMP-CCR) de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Role of major resection in pulmonary metastasectomy for colorectal cancer in the spanish prospective multicenter study (GECMP-CCR). Ann Oncol. 2016;27:850–5.

    Article  PubMed  Google Scholar 

  56. 56.

    Mondello B, Lentini S, Barone M, Barresi P, Monaco F, Familiari D, et al. Surgical management of pulmonary inflammatory pseudotumors: a single center experience. J Cardiothorac Surg. 2011;6:18.

    Article  PubMed  PubMed Central  Google Scholar 

  57. 57.

    Ichinose J, Kohno T, Fujimori S. Video-assisted thoracic surgery for pulmonary aspergilloma. Interact Cardiovasc Thorac Surg. 2010;10:927–30.

    Article  PubMed  Google Scholar 

  58. 58.

    Matsuoka K, Imanishi N, Matsuoka T, Nagai S, Ueda M, Miyamoto Y. Video-assisted thoracoscopic surgery for nontuberculous mycobacterial infection. Asian Cardiovasc Thorac Ann. 2014;22:1066–71.

    Article  PubMed  Google Scholar 

  59. 59.

    Tsuchida M, Aoki K, Hashimoto T, Yamato Y, Hayashi J. Segmental bronchial atresia of the left upper lobe treated with segmental resection under video-assisted thoracic surgery. Surg Laparosc Endosc Percutan Tech. 2001;11:217–20.

    CAS  Article  PubMed  Google Scholar 

  60. 60.

    Cappeliez S, Lenoir S, Validire P, Gossot D. Totally endoscopic lobectomy and segmentectomy for congenital bronchial atresia. Eur J Cardiothorac Surg. 2009;36:222–4.

    Article  PubMed  Google Scholar 

  61. 61.

    Pan X, Zhang Y, Li X, Ding Z, Zhu D, Zhang C, Zhao J. Video-assisted thoracoscopic segmentectomy of lingual segment of the left upper pulmonary lobe for chronic focal bronchiectasis. J Thorac Dis. 2016;8:628–30.

    Article  PubMed  PubMed Central  Google Scholar 

  62. 62.

    Ishikawa Y, Yamanaka K, Nishii T, Fujii K, Rino Y, Maehara T. Video-assisted thoracoscopic surgery for pulmonary arteriovenous malformations: report of five cases. Gen Thorac Cardiovasc Surg. 2008;56:187–90.

    Article  PubMed  Google Scholar 

  63. 63.

    Inoue T, Oizumi H, Nakamura M, Sadahiro M. Port-access thoracoscopic anatomical segmentectomy for pediatric intralobar pulmonary sequestration. Thorac Cardiovasc Surg Rep. 2014;3:42–4.

    Article  PubMed  PubMed Central  Google Scholar 

  64. 64.

    Finley RJ, Mayo JR, Grant K, Clifton JC, English J, Leo J, Lam S. Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: a prospective randomized controlled trial. J Thorac Cardiovasc Surg. 2015;149:26–31.

    Article  PubMed  Google Scholar 

  65. 65.

    Donahoe LL, Nguyen ET, Chung TB, Kha LC, Cypel M, Darling GE, et al. CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature. J Thorac Dis. 2016;8:1986–94.

    Article  PubMed  PubMed Central  Google Scholar 

  66. 66.

    Shentu Y, Zhang L, Gu H, Mao F, Cai M, Ding Z, Wang Z. A new technique combining virtual simulation and methylene blue staining for the localization of small peripheral pulmonary lesions. BMC Cancer. 2014;14:79.

    Article  PubMed  PubMed Central  Google Scholar 

  67. 67.

    Magistrelli P, D’Ambra L, Berti S, Feleppa C, Stefanini T, Falco E. Use of india ink during preoperative computed tomography localization of small peripheral undiagnosed pulmonary nodules for thoracoscopic resection. World J Surg. 2009;33:1421–4.

    Article  PubMed  Google Scholar 

  68. 68.

    Horan TA, Pinheiro PM, Araújo LM, Santiago FF, Rodrigues MR. Massive gas embolism during pulmonary nodule hook wire localization. Ann Thorac Surg. 2002;73:1647–9.

    Article  PubMed  Google Scholar 

  69. 69.

    Sakiyama S, Kondo K, Matsuoka H, Yoshida M, Miyoshi T, Yoshida S, Monden Y. Fatal air embolism during computed tomography-guided pulmonary marking with a hook-type marker. J Thorac Cardiovasc Surg. 2003;126:1207–9.

    Article  PubMed  Google Scholar 

  70. 70.

    Shimizu K, Nagashima T, Ohtaki Y, Obayashi K, Nakazawa S, Kamiyoshihara M, et al. Analysis of the variation pattern in right upper pulmonary veins and establishment of simplified vein models for anatomical segmentectomy. Gen Thorac Cardiovasc Surg. 2016;64:604–11.

    Article  PubMed  PubMed Central  Google Scholar 

  71. 71.

    Akiba T, Marushima H, Kamiya N, Odaka M, Kinoshita S, Takeyama H, Morikawa T. Thoracoscopic surgery for pulmonary metastases after chemotherapy using a tailor-made virtual lung. Gen Thorac Cardiovasc Surg. 2011;59:413–7.

    Article  PubMed  Google Scholar 

  72. 72.

    Oizumi H, Kanauchi N, Kato H, Endoh M, Suzuki J, Fukaya K, Sadahiro M. Anatomic thoracoscopic pulmonary segmentectomy under 3-dimensional multidetector computed tomography simulation: a report of 52 consecutive cases. J Thorac Cardiovasc Surg. 2011;141:678–82.

    Article  PubMed  Google Scholar 

  73. 73.

    Akiba T. Utility of three-dimensional computed tomography in general thoracic surgery. Gen Thorac Cardiovasc Surg. 2013;61:676–84.

    Article  PubMed  Google Scholar 

  74. 74.

    Hagiwara M, Shimada Y, Kato Y, Nawa K, Makino Y, Furumoto H, et al. High-quality 3-dimensional image simulation for pulmonary lobectomy and segmentectomy: results of preoperative assessment of pulmonary vessels and short-term surgical outcomes in consecutive patients undergoing video-assisted thoracic surgery†. Eur J Cardiothorac Surg. 2014;46:e120–6.

    Article  PubMed  Google Scholar 

  75. 75.

    Chen-Yoshikawa TF, Date H. Update on three-dimensional image reconstruction for preoperative simulation in thoracic surgery. J Thorac Dis. 2016;8:S295–301.

    Article  PubMed  PubMed Central  Google Scholar 

  76. 76.

    Fukuhara K, Akashi A, Nakane S, Tomita E. Preoperative assessment of the pulmonary artery by three-dimensional computed tomography before video-assisted thoracic surgery lobectomy. Eur J Cardiothorac Surg. 2008;34:875–7.

    Article  PubMed  Google Scholar 

  77. 77.

    Nagashima T, Shimizu K, Ohtaki Y, Obayashi K, Kakegawa S, Nakazawa S, et al. An analysis of variations in the bronchovascular pattern of the right upper lobe using three-dimensional CT angiography and bronchography. Gen Thorac Cardiovasc Surg. 2015;63:354–60.

    Article  PubMed  PubMed Central  Google Scholar 

  78. 78.

    Yamada S, Suga A, Inoue Y, Iwazaki M. Importance of preoperative assessment of pulmonary venous anomaly for safe video-assisted lobectomy. Interact Cardiovasc Thorac Surg. 2010;10:851–4.

    Article  PubMed  Google Scholar 

  79. 79.

    Akiba T, Morikawa T, Marushima H, Nakada T, Inagaki T, Ohki T. Computed tomography guided thoracoscopic segmentectomy for lung cancer with variant bronchus. Ann Thorac Cardiovasc Surg. 2014;20:407–9.

    Article  PubMed  Google Scholar 

  80. 80.

    Oizumi H, Endoh M, Takeda S, Suzuki J, Fukaya K, Sadahiro M. Anatomical lung segmentectomy simulated by computed tomographic angiography. Ann Thorac Surg. 2010;90:1382–3.

    Article  PubMed  Google Scholar 

  81. 81.

    Sato M, Yamada T, Menju T, Aoyama A, Sato T, Chen F, et al. Virtual-assisted lung mapping: outcome of 100 consecutive cases in a single institute. Eur J Cardiothorac Surg. 2015;47:e131–9.

    Article  PubMed  Google Scholar 

  82. 82.

    Saji H, Inoue T, Kato Y, Shimada Y, Hagiwara M, Kudo Y, et al. Virtual segmentectomy based on high-quality three-dimensional lung modelling from computed tomography images. Interact Cardiovasc Thorac Surg. 2013;17:227–32.

    Article  PubMed  PubMed Central  Google Scholar 

  83. 83.

    Shimizu K, Nakano T, Kamiyoshihara M, Takeyoshi I. Segmentectomy guided by three-dimensional computed tomography angiography and bronchography. Interact Cardiovasc Thorac Surg. 2012;15:194–6.

    Article  PubMed  PubMed Central  Google Scholar 

  84. 84.

    Iwano S, Yokoi K, Taniguchi T, Kawaguchi K, Fukui T, Naganawa S. Planning of segmentectomy using three-dimensional computed tomography angiography with a virtual safety margin: technique and initial experience. Lung Cancer. 2013;81:410–5.

    Article  PubMed  Google Scholar 

  85. 85.

    Gonzalez-Rivas D, Mendez L, Delgado M, Fieira E, Fernandez R, de la Torre M. Uniportal video-assisted thoracoscopic anatomic segmentectomy. J Thorac Dis. 2013;5(Suppl 3):S226–33.

    PubMed  PubMed Central  Google Scholar 

  86. 86.

    Gonzalez-Rivas D, Yang Y, Lei J, Hernandez L, Jiang G. Subxiphoid uniportal video-assisted thoracoscopic middle lobectomy and anterior anatomic segmentectomy (S3). J Thorac Dis. 2016;8:540–3.

    Article  PubMed  PubMed Central  Google Scholar 

  87. 87.

    Tsubota N. An improved method for distinguishing the intersegmental plane of the lung. Surg Today. 2000;30:963–4.

    CAS  Article  PubMed  Google Scholar 

  88. 88.

    Okada M, Mimura T, Ikegaki J, Katoh H, Itoh H, Tsubota N. A novel video-assisted anatomic segmentectomy technique: selective segmental inflation via bronchofiberoptic jet followed by cautery cutting. J Thorac Cardiovasc Surg. 2007;133:753–8.

    Article  PubMed  Google Scholar 

  89. 89.

    Sekine Y, Ko E, Oishi H, Miwa M. A simple and effective technique for identification of intersegmental planes by infrared thoracoscopy after transbronchial injection of indocyanine green. J Thorac Cardiovasc Surg. 2012;143:1330–5.

    Article  PubMed  Google Scholar 

  90. 90.

    Miyasaka Y, Oh S, Takahashi N, Takamochi K, Suzuki K. Postoperative complications and respiratory function following segmentectomy of the lung - comparison of the methods of making an inter-segmental plane. Interact Cardiovasc Thorac Surg. 2011;12:426–9.

    Article  PubMed  Google Scholar 

  91. 91.

    Tao H, Tanaka T, Hayashi T, Yoshida K, Furukawa M, Yoshiyama K, Okabe K. Influence of stapling the intersegmental planes on lung volume and function after segmentectomy. Interact Cardiovasc Thorac Surg. 2016;23:548–52.

    Article  PubMed  Google Scholar 

  92. 92.

    Kuroda H, Dejima H, Mizumo T, Sakakura N, Sakao Y. A new ligasure technique for the formation of segmental plane by intravenous indocyanine green fluorescence during thoracoscopic anatomical segmentectomy. J Thorac Dis. 2016;8:1210–6.

    Article  PubMed  PubMed Central  Google Scholar 

  93. 93.

    Asakura K, Izumi Y, Kohno M, Ohtsuka T, Okui M, Hashimoto K, et al. Effect of cutting technique at the intersegmental plane during segmentectomy on expansion of the preserved segment: comparison between staplers and scissors in ex vivo pig lung. Eur J Cardiothorac Surg. 2011;40:e34–8.

    Article  PubMed  Google Scholar 

  94. 94.

    Pardolesi A, Park B, Petrella F, Borri A, Gasparri R, Veronesi G. Robotic anatomic segmentectomy of the lung: technical aspects and initial results. Ann Thorac Surg. 2012;94:92–34.

    Article  Google Scholar 

  95. 95.

    Kent M, Wang T, Whyte R, Curran T, Flores R, Gangadharan S. Open, video-assisted thoracic surgery, and robotic lobectomy: review of a national database. Ann Thorac Surg. 2014;97:236–42.

    Article  PubMed  Google Scholar 

  96. 96.

    Cerfolio RJ, Watson C, Minnich DJ, Calloway S, Wei B. One hundred planned robotic segmentectomies: early results, technical details, and preferred port placement. Ann Thorac Surg. 2016;101:1089–95.

    Article  PubMed  Google Scholar 

  97. 97.

    Wilson JL, Louie BE, Cerfolio RJ, Park BJ, Vallières E, Aye RW, et al. The prevalence of nodal upstaging during robotic lung resection in early stage non-small cell lung cancer. Ann Thorac Surg. 2014;97:1901–6.

    Article  PubMed  Google Scholar 

  98. 98.

    Echavarria MF, Cheng AM, Velez-Cubian FO, Ng EP, Moodie CC, Garrett JR, et al. Comparison of pulmonary function tests and perioperative outcomes after robotic-assisted pulmonary lobectomy vs segmentectomy. Am J Surg. 2016;212:1175–82.

    Article  PubMed  Google Scholar 

  99. 99.

    Demir A, Ayalp K, Ozkan B, Kaba E, Toker A. Robotic and video-assisted thoracic surgery lung segmentectomy for malignant and benign lesions. Interact Cardiovasc Thorac Surg. 2015;20:304–9.

    Article  PubMed  Google Scholar 

  100. 100.

    Liang H, Liang W, Zhao L, Chen D, Zhang J, Zhang Y, et al. Robotic versus video-assisted lobectomy/segmentectomy for lung cancer: a meta-analysis. Ann Surg. 2017. https://doi.org/10.1097/SLA.0000000000002346.

Download references

Author information

Affiliations

  1. Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Seshiru Nakazawa, Kimihiro Shimizu, Akira Mogi & Hiroyuki Kuwano

Authors
  1. Seshiru Nakazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kimihiro Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akira Mogi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroyuki Kuwano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kimihiro Shimizu.

Ethics declarations

Conflict of interest

The authors have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Nakazawa, S., Shimizu, K., Mogi, A. et al. VATS segmentectomy: past, present, and future. Gen Thorac Cardiovasc Surg 66, 81–90 (2018). https://doi.org/10.1007/s11748-017-0878-6

Download citation

Keywords

  • Video-assisted thoracoscopic surgery
  • VATS
  • Segmentectomy