Intro
Acknowledgments
Introduction
Symbols
Contents
I: General Considerations
1: Anatomical Variations to Know for Thoracoscopic Major Pulmonary Resections
1.1 Right Lung
1.1.1 Right Upper Lobe
1.1.2 Middle Lobe
1.1.3 Right Lower Lobe
1.2 Left Lung
1.2.1 Left Upper Lobe
1.2.2 Lower Lobe
References
2: Target Localization for Thoracoscopic Major Pulmonary Resections
2.1 Background
2.2 CT-Guided Percutaneous Techniques
2.2.1 Hookwire Positioning
2.2.2 Dye Marking Techniques
2.2.3 Placement of Microcoils or Fiducials Markers

2.2.4 Injection of Contrast Material
2.2.5 Radiotracer-Guided Localization
2.2.6 Double Localization
2.2.7 CT-Guided Localization in a Hybrid Operating Room
2.3 Endobronchial Techniques
2.3.1 Marking Via Endobronchial Ultrasound Radial Probe Guidance (r-EBUS)
2.3.2 Marking Via Electromagnetic Navigation Bronchoscopy (ENB)
2.4 Other Techniques
2.5 Conclusions
References
3: Basics for Thoracoscopic Major Pulmonary Resections
3.1 Ergonomics and Operating Room Setting
3.2 Ports
3.3 Enhancing Vision and Video-Imaging

3.4 Operating with the Optimal Angle of Vision
3.5 Keeping a Stable Image
3.6 Operating with a Clean Lens
3.7 Operating with a Clear Image
3.8 Obtaining a Pathological Diagnosis
3.9 Instruments
3.10 Exposure and Lung Retraction
3.11 Fissures
3.12 Exposure of Bronchial and Vascular Elements
3.13 Vascular Control
3.14 Manual Suturing
3.15 Specimen Retrieval
3.16 3D Modelization
References
4: Complications of Thoracoscopic Major Pulmonary Resections
4.1 Minor Complications
4.1.1 Pulmonary Injuries By Trocar
4.1.2 Diaphragmatic Wound

4.1.3 Bronchial Wound
4.1.4 Thoracic Duct Injury
4.1.5 Minor Bleeding
4.1.6 Defective Stapling
4.1.7 Air Leakage
4.1.8 Equipment-Related Accidents
4.1.9 Pulmonary Hernia
4.2 Serious Complications
4.2.1 Major Vascular Injuries
4.2.2 Esophageal Injury
4.2.3 Torsion
4.2.4 Venous Ischemia
References
5: Thoracoscopic Lymph Node Dissection
5.1 Definition
5.2 Specific Issues Related to the Thoracoscopic Approach
5.3 Technique
5.3.1 Stations 11-12-13
5.3.2 Station 10
5.3.3 Stations 9 and 8
5.3.4 Station 7 (Left Side Approach)

5.3.5 Stations 5 and 6
5.3.6 Station 7 (Right Side Approach)
5.3.7 Stations 4R and 2R
5.3.8 Station 3A
References
II: Lobectomies
6: Right Upper Lobectomy
6.1 Anatomical Landmarks
6.2 Anatomical Variations and Pitfalls
6.3 Technique
6.3.1 Fissure and Posterior Ascending Artery (A2)
6.3.2 Bronchus
6.3.3 Truncus Anterior
6.3.4 Vein
6.3.5 Minor Fissure Division
6.3.6 Division of the Pulmonary Ligament
6.3.7 Securing the Middle Lobe
References
7: Right Middle Lobectomy and Upper-Middle Bilobectomy
7.1 Anatomical Landmarks