Anterior unidirectional approach in a uniportal thoracoscopic anterior segmentectomy (S3) of the right upper lobe for a dense fissure.

Most types of segmentectomies require dissection of a fissure to expose the pulmonary arteries, which is considered a conventional technique. Therefore, it is necessary to deal with a dense fissure in a pulmonary segmentectomy as well as in a lobectomy. Nevertheless, only a few reports describe the operative technique for managing a dense fissure in a pulmonary segmentectomy. Although a dense fissure is frequently found between the right upper and the middle lobes, only one previous report has described an anterior segmentectomy (S3) of the right upper lobe without the dissection of a dense fissure between the right upper and middle lobes. In this video tutorial, we show the appropriate surgical steps for a right S3 segmentectomy using an anterior unidirectional approach via uniportal thoracoscopy for a patient with a dense fissure.