Thoracoscopic anterior segmentectomy of the right upper lobe (S³)

S³ segmentectomy is a challenging procedure for three reasons: the anatomy of vascular elements is complex, the segment is comprised between S¹ and the middle lobe, and the minor fissure is most often fused. The key for accessing the bronchovascular pedicle is two-fold: (I) achieving a sufficient exposure of the bronchial trifurcation and (II) opening of the minor fissure between S³ and the middle lobe. Once done, this maneuver helps exposing the vessels and greatly eases the procedure.