Robotic Right Lower Lobe Anterobasal (S8) Segmentectomy

<p>Segmentectomy is indicated in selected patients with non-small-cell lung cancer with peripheral nodules measuring ≤ 2 cm and a ≥ 50% ground-glass appearance on computed tomography (CT) (1). We report the case of an 80-year-old asymptomatic man with a history of symptomatic epilepsy, who underwent CT for an unrelated condition and was shown to have a peripheral lung nodule (1.5 cm) in the right S8 segment with a 50% ground-glass appearance. Positron emission tomography-CT revealed that the maximum standardized uptake value of the nodule was 2.2, without fluorodeoxyglucose uptake at any other site. The patient underwent robotic right lower lobe anterobasal segmentectomy.</p> <p>The chest tube was removed on postoperative day 2, and the patient was discharged uneventfully. Histopathological examination showed adenocarcinoma stage pT1aN0M0.</p> <p> </p> <p>Following are the recommendations we wish to highlight:</p> <p>1. Careful and detailed preoperative CT evaluation is essential to confirm the anatomical structures and their orientation in a patient</p> <p>2. Adequate dissection of the pulmonary artery should be performed to accurately determine the anatomy of the relevant structures</p> <p>3. Bronchoscopic evaluation is helpful to accurately identify the target bronchus</p> <p>4. Indocyanine green fluorescence imaging is an easy and effective method to identify the segmental boundary</p> <p>5. If possible, the peripheral bronchial stump should be pulled toward the site of resection during parenchymal separation (lung segment resection) using a linear cutter stapler</p> <p>Reference</p> <p>1. National Comprehensive Cancer Network. Non-Small-Cell Lung Cancer (Version 5. 2021). http://www.nccn.org/professionals/physician_gls/pdf/nsclc.pdf</p>