Technical aspects of biportal video-assisted thoracoscopic S10 segmentectomy of the lung: fissureless posterior approach

The technical aspects of the biportal approach for postero-basal segmentectomy are described. The approach is a fissure-less one. The first and most important step is the identification and division of the postero-basal segmental vein in the posterior hilum of the lung. The division of the segmental vein is essential to expose the segmental bronchus, which is divided next. The segmental bronchus is in close relationship with the A10 segmental artery, which is divided next. The fissure is not violated in any of the steps presented in this technique. Finally the intersegmental plane is completed along the inflation-deflation line using endostaplers.