RATS En Block Resection of Right Upper Lobe and Lower Lobe Superior Segment

The patient featured in this video is a seventy-seven-year-old asymptomatic woman with a history of hypertension who underwent computed tomography (CT) for a medical check. The CT revealed two peripheral consolidations in the right upper lobe (superior and posterior segment, respectively) and a 5 mm nodule in the middle lobe. Upper lobe posterior segment (S2) consolidation had invaded the lower lobe superior segment (S6) with an incomplete fissure. A positron emission tomography CT revealed that the maximum standardized uptake value of the two consolidations in the right upper lobe was 3.5 in S1 and 4.1 in S2, without fluorodeoxyglucose uptake at any other site. They were suspected of lung cancer, and the patient underwent surgery. The intraoperative cytology showed class V. Therefore, the patient underwent a robotic en bloc resection of the right upper lobe, lower lobe superior segment, and parts of the middle lobe. 

Postoperatively, the patient developed idiopathic subglottic stenosis but recovered with tracheal intubation and corticosteroid for several days. She walked out of the hospital on postoperative day twenty. The histopathological examination showed lepidic adenocarcinoma in S1, papillary adenocarcinoma in S2, and carcinoma in situ in the middle lobe, pT2aN0M0.