An improved method for distinguishing the intersegmental plane of the lung

Abstract

An improved technique for distinguishing the intersegmental plane of the lung was developed as follows. After the involved bronchus is identified, the lobe is inflated and the segmental bronchus is then tied to maintain gas inside of the segments that will be removed, and thereafter is severed at a point proximal to the tie. When almost done closing the stump, a line will develop between the deflated and the inflated area, which represents the intersegmental plane to be operated on. This technique is therefore completely different from the technique described in textbooks, in which the preserved segment is kept inflated while the resected one is kept deflated. Once the line develops, one can operate just on the line using either electrocautery under adequate tension or staples between the collapsed and inflated segments. The cutting surface is so close to the real intersegmental plane that the amounts of air leak and bleeding are negligible.