Uniportal VATS sleeve resection of the right upper lobe

Incision of approximately 4 cm in length in the area of the anterior axillary line at the upper edge of the 5th rib to access the 4th intercostal space above. A helpful orientation is often an imaginary line from the tip of the scapula to the nipple. Transection of the subcutaneous tissue on the rib with the monopolar knife. Subsequently, stepwise preparation of the intercostal musculature with the monopolar knife. The pleura is opened bluntly with a finger. Palpation of the thoracic wall for adhesions and insertion of a wound protection film.

First, the exploration of the thorax and the release of minor adhesions follows. Subsequently, the exposure of the lung hilum begins with incision and blunt dissection of the pleural covering, and exposure of the anterior trunk of the right pulmonary artery and the upper pulmonary vein.

Now the partial exposure of the anterior trunk is completed and circumferentially, bluntly dissected. Subsequently, the artery can be safely transected using an endoscopic stapling device after traction.

After detaching the anterior trunk, there is now sufficient space to continue the dissection of the superior pulmonary vein. Care must be taken to observe a possible confluence of the middle lobe vein. The vein is bluntly dissected in a circular manner.

By visualizing the superior pulmonary vein, the pulmonary artery, and the entry of the middle lobe vein, the minor fissure can be transected using a stapling device, guided by these anatomical landmarks.