Uniportal thoracoscopic posterior basal (S10) segmentectomy using a posterior approach

Performing a posterior basal (S10) segmentectomy through a single port is challenging because of the dorsal location of the S10 segment in the lower lobe. The vessels and bronchi to be resected are located deep and away from the major fissure, which makes exposure from the interlobar fissure difficult. To avoid unnecessary parenchymal splitting and potential misrecognition of segmental structures, we performed a uniportal thoracoscopic S10 segmentectomy via a posterior approach without extensively separating the pulmonary parenchyma from the interlobar fissure. When using this approach, placement of an endostapler directed towards the targeted segmental structures is reasonable, and division of the parenchyma between segments S6 and S10 from the dorsal side of the lower lobe using a staple enables excellent exposure of the segmental pulmonary artery (A10).