Uncommon segmentectomies: upper lobe apical (S1) and posterior (S2) segmentectomy

A combined resection of the apicoposterior segments (S1+S2) of the upper lobes is regarded to be an uncommon segmental resection. The benefits of saving the anterior segment (S3) seem small, while augmenting the technical difficulty of the resection in comparison to a classic S1+S2+S3 resection, being a right upper lobectomy or left lingula sparing lobectomy. However, a spared S3 is usually surprisingly large and nicely supports the remaining middle lobe on the right and the lingula on the left. In this paper, we discuss the anatomy, procedure and pitfalls concerning VATS anatomical S1+S2 resections.