A uniportal thoracoscopic fissureless lingual segmentectomy for a patient with a dense fissure.

Postoperative prolonged air leak is one of the most common morbidities in general thoracic surgery, and a dense fissure is considered to be one of the main causes of prolonged air leak. In a patient with a dense fissure, the fissureless technique is considered one of the most useful options to avoid prolonged air leak, which has been reported in several previous articles after a lobectomy. However, there are few reports describing the operative technique to treat a dense fissure via a pulmonary segmentectomy, although the management of a dense fissure is necessary in a pulmonary segmentectomy as well as in a lobectomy. In this video tutorial, we show the successful results of a left lingual segmentectomy using the fissureless technique via a uniportal thoracoscopy in a patient with a dense fissure. Special emphasis was placed on how to divide the dominant pulmonary vessels and bronchus given the limited angulation of the inserted stapler.