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In lobectomy, it is essential to isolate and transect the supplying structures corresponding to the lobe. In the lobectomy of the right lower lobe, these are the inferior pulmonary vein, the basal part of the pulmonary artery with the branch of the artery of the 6th segment (A6), and the right lower lobe bronchus with the branch of the bronchus of the 6th segment (B6).
- Bronchus: The right lower lobe bronchus includes the 4 basal segmental bronchi (B7-B10) and the apical segment 6 bronchus (B6). The segmental bronchus B6 is the first branch of the lower lobe bronchus and is usually located opposite and slightly below the middle lobe bronchus. After the branch of the segment 6 bronchus (B6), the common trunk of the 4 lower lobe segmental bronchi (B7-B10), which is about 10 to 15mm long, begins.
- Artery: In the fissure, the interlobar part of the pulmonary artery can be displayed. After the branches to the middle lobe, the apical branch of the A6 artery to the 6th segment (A6) appears, analogous to the bronchial system, followed by the basal part as the union of the 4 lower lobe segmental arteries (A7-A10).
- Vein: The lower lobe drains its blood into the heart after the confluence of the 6th segment vein (V6) with the basal vein of the lower 4 segments as the lower lobe vein. This can usually be well displayed after preparation of the pulmonary ligament. Occasionally, the middle lobe vein may drain into the lower instead of the upper pulmonary vein.