Sleeve Left Upper Lobectomy (Vascular Control, PostTB patient) [Video]

This video contains case presentation and surgical video – minimally invasive resection of centrally located lung tumor. Patient was diagnosed with the left upper lobe squamous cell carcinoma which was involving the takeoff of left upper lobe bronchus and there was also a suspicion of the left pulmonary artery involvement. There were no evidence of mediastinal involvement or distant spread of the disease. Patient’s pulmonary function was already decreased due to smoking exposure and consequences of the previous pulmonary tuberculosis. To avoid pneumonectomy, sleeve resection was proposed. We performed uniportal VATS left upper lobectomy with bronchial sleeve resection and small tangential resection of the left pulmonary artery as well as systematic mediastinal lymph node dissection. Proximal and distal vascular control was obtained to safely manage possible invasion of pulmonary artery. Bronchial anastomosis between the left main bronchus and lower lobe bronchus was made with running suture. Anastomosis healed well and postoperative period was uneventful.