Thoracoscopic S1 Segmentectomy, Right Upper Lobe: Alternative Posterior Approach

Minimally-invasive pulmonary segmentectomy is an effective method for treating selective cases while preserving lung parenchyma and minimizing perioperative morbidity and length of hospital stay. A fully thoracoscopic multiport approach is often preferred due to its straightforwardness and flexibility, allowing adaptation to unexpected intraoperative findings.  

The S1 (apical) segment of the right upper lobe poses challenges for a conventional anterior approach due to its complex vascular anatomy. A posterior approach may address these challenges by providing direct access to the segmental bronchus and better alignment for dissection for the apical artery, however, success depends on individual anatomy.