In lobectomy, it is important to isolate and transect the supplying structures associated with the respective lobe. In a sleeve resection or bronchoplastic resection, additional sections of the bronchial system are resected, and the subsequent lung tissue is preserved through anastomosis. In an upper sleeve lobectomy on the right, both the upper lobe bronchus and the bronchus intermedius are resected and anastomosed with the right main bronchus. The management of veins and arteries is done in the same way as in a simple lobectomy of the upper lobe.
- Bronchus: The right main bronchus is between 1cm and 2.5cm long. The upper lobe bronchus opens ventrolaterally and is oriented apicolaterally. It divides into the 3 segmental bronchi B1 apical, B2 posterior, and B3 anterior. After the branching of the right upper lobe bronchus, the bronchus intermedius begins, which is about 1 to 3cm long, at the caudal end of which the middle lobe bronchus opens from anterolateral and opposite the B6 segmental bronchus.
- Artery: The right upper lobe is supplied by the first two branches of the pulmonary artery, the truncus anterior (common trunk of A1 + A3) and the segment 2 artery A2.
- Vein: The upper lobe drains its blood into the superior pulmonary vein, into which the middle lobe vein also drains in most cases.