Right Upper Lobe Microlobectomy With the Double Double

This is a right upper lobe microlobectomy and the author uses the stapler to perform a double stapling twice, hence the “Double Double!”

The procedure shown in this video is the microlobectomy technique, which is fully described at www.microlobectomy.com (1).

The author did a lymphadenectomy, then dissected out the right upper lobe vein and the truncal branch of the pulmonary artery. He transected both of these vessels with a single Tan 45 stapler from the subxiphoid port.

The author then dissected out the posterior ascending artery and the right upper lobe bronchus, again dividing them both with a single stapler as they lined up very nicely with the stapler coming from the subxiphoid port.

The author also used the Surgiwand™ (Covidien, Dublin, Ireland) in this video. It is a hook diathermy and also a sucker in one, which means that one does not have to remove the hook from the surgical field when they want to do some suction.

References

1. Dunning J, Elsaegh M, Nardini M, et al. Microlobectomy: a novel form of endoscopic lobectomy. Innovations (Phila). 2017;12(4):247-253.