Segmentectomies Made Easy series: robotic-assisted left S3 segmentectomy

Robotic-assisted thoracic surgery is increasingly recognized as a valuable approach for the most complex of pulmonary resections, offering high-definition 3D visualization, enhanced instrument articulation and tremor-free precision. Compared to open thoracotomy, the robotic platform is associated with reduced peri-operative morbidity, shorter hospital stays and faster post-operative recovery. However, sublobar resections such as segmentectomies remain technically demanding, particularly in the context of anatomical variations, as illustrated in this case. The integration of 3D reconstruction imaging allows for meticulous pre-operative assessment of bronchovascular anatomy, enabling tailored surgical planning and more accurate dissection. Despite these clear advantages, the routine application of 3D virtual modelling in thoracic surgery is still underutilized and remains insufficiently represented in the existing body of evidence. This video tutorial is the third entry in the 'Segmentectomies Made Easy' atlas and demonstrates a robotic left S3 segmentectomy performed for a metastatic pulmonary lesion. Pre-operative 3D imaging revealed distinct anatomical variants, which played a pivotal role in shaping the dissection strategy. The tutorial provides a structured, step-by-step account of the procedure, from port placement to segmental resection and complex anatomical identification, emphasizing how 3D visualization can enhance surgical accuracy, improve intra-operative decision-making and optimize outcomes in robotic segmentectomy.