Page 35 - Read Online

Gharagozloo et al. Mini-invasive Surg 2020;4:55 I http://dx.doi.org/10.20517/2574-1225.2020.42 Page 11 of 13

Figure 15. View of the divided transverse fissure. UL: upper lobe; ML: middle lobe

Figure 16. The pulmonary artery branch to the lower lobe (RLLA) is identified. The SSPA is identified. RLLA: right lower lobe pulmonary
artery; SSPA: superior segmental artery

layer and the superior segmental branch of the lower lobe pulmonary artery is identified. The major fissure
is then divided from an anterior to posterior direction using a stapler which is introduced from the anterior
port.

The pulmonary artery branch to the lower lobe is identified. At times the superior segmental pulmonary
artery and the inferior lower lobe segmental artery can be taken by encircling the pulmonary artery
proximal to the takeoff of the superior segmental artery. Other times these branches need to be taken
separately. We prefer to take the inferior segmental artery first, thereby making the encirclement of the
superior segmental artery easier [Figure 16].

Next, the posterior aspect of the oblique fissure is divided using a stapler with a purple cartridge. Finally,
the bronchus is encircled and divided using a purple cartridge [Figure 17]. The lower lobe is removed as
described earlier.

CONCLUSION
Robotic Lobectomy has been evolving over the past decade and is an oncologically acceptable procedure.
A methodical approach to the conduct of the lobectomies and a proven strategy for the control of major
vascular injury will increase adoption. The technique of Robotic Lobectomy Part II outlines the technique