Innovative segmentectomy to remove the posterior segment of the lower lobe (S10) of the lung

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Abstract
We describe our innovative technique for performing segmentectomy of the posterior segment of the lower lobe of the lung, being segment number 10 (S10). In segmentectomy of S10, it is difficult to identify A10 from the interlobar fissure because the pulmonary artery to S10 (A10) branches from A9+10 and runs dorsally and deeply into the lung tissue. Moreover, to reach S10 from the interlobar fissure, the lung tissue should be cut between S6 and S8, because S10 is not located beside the interlobar fissure. However, it is difficult to identify the boundary between the S6 and S8 without a route marker. To solve these difficulties, we divided S6 and S10 from each other at the beginning of the procedure, which enabled A10 to be identified easily from the dorsal side. Because S6 and S8–10 should be divided in S10 segmentectomy at the end, the division between S6 and S8–10 at the beginning of procedure is not only reasonable, but makes the procedure simple.

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