Thoracoscopic Left Lower Lobectomy for Metastatic Osteosarcoma in a 20-Year-Old

The 5 millimeter cool seal with its fine dissecting tips and dual action jaws allows for excellent dissection around delicate structures.

In smaller patients, the surgeon will often take the pulmonary artery vessel at the segmental level, using the cool seal to seal the vessel and safely divide it.

In a larger patient, it is often more efficient to find the pulmonary artery to the lower lobe as it crosses through the fissure, allowing the surgeon to get the main trunk above the bifurcation to the apical and basal segments and use a vascular stapler to safely take the vessel, saving time compared to dissecting into the lung to find the segmental vessels.

In many cases, the surgeon will take the bronchus next after the pulmonary artery as it presents itself before taking the inferior pulmonary vein.

In this case, because of the large tumor and the large amount of inflammation in this area, dissection of the bronchus was difficult, and the surgeon did not want to injure the vein in dissecting this out, so approached the inferior pulmonary ligament instead.