Uniportal trisegmentectomy S1-3 left with ICG

Incision of approximately 4 cm in length in the area of the anterior axillary line at the upper edge of the 5th rib to access the overlying 4th intercostal space. A helpful orientation is often an imaginary line from the tip of the scapula to the nipple. Transection of the subcutis on the rib with the monopolar knife. Subsequently, stepwise preparation of the intercostal muscles with the monopolar knife. The pleura is opened bluntly with fingers. Palpation of the thoracic wall for adhesions and insertion of a wound protection foil.

The operation begins with the preparation of the lung hilum. Initially, the pleural covering is incised, taking care to preserve the phrenic nerve. Subsequently, the pulmonary artery and the pulmonary veins can be gradually exposed through mostly blunt dissection (spreading or pushing).

A large lymph node from station 10 according to IALSCC (lung hilum) is exposed and should be removed even in non-oncological surgeries to facilitate further preparation at the hilum.