Department of Thoracic Surgery Successfully Performed Simultaneous Bilateral Single-Port Video-Assisted Thoracoscopic Left Lung Wedge Resection + Right Lung Combined Segmentectomy

A 39-year-old male patient, Mr. Xu, was found to have multiple high-risk pulmonary nodules during a physical examination, including one in the left lower lobe and two in the right lower lobe. After consulting several major tertiary hospitals both locally and nationally, Mr. Xu chose to visit the Department of Thoracic Surgery at HeYou Hospital upon the recommendation of a friend.

Considering the patient's desire to have all nodules removed in a single surgery, bilateral thoracic surgery posed a significant challenge to the patient's pulmonary function and postoperative respiratory recovery, placing great demands on the entire anesthesia and surgical team. On one hand, the anesthesia team needed to precisely manage bilateral lung ventilation, as any minor deviation could jeopardize the patient's respiratory function and surgical safety. On the other hand, due to the small size of the nodules, influenced by lung tissue movement and respiratory motion, localization was significantly more difficult, potentially affecting surgical precision. To address this, the team led by Director Gao Kunxiang of the Department of Thoracic Surgery utilized three-dimensional reconstruction technology to process CT imaging data before surgery, clearly visualizing the bronchus, pulmonary arteries, and veins of the lung segments containing the right lower lobe nodules. They planned the pulmonary segmental arteries, veins, and segmental bronchi to be resected, laying a solid foundation for a smooth surgical procedure. Preoperatively, CT-guided placement of a hook-wire localization needle was performed to precisely locate the nodule in the left lower lobe. During the surgery, the surgical team and anesthesia team worked in close coordination. The anesthesia team remained fully focused to ensure stable bilateral lung ventilation, while the surgical team performed a precise wedge resection of the left lower lobe nodule and a combined anterior and lateral basal segmentectomy of the right lower lobe nodule. The surgery proceeded smoothly, and intraoperative pathological examination revealed that all three pulmonary nodules were adenocarcinoma in situ.

Postoperatively, the hospital implemented a rapid recovery strategy, including early chest tube removal and cough and sputum drainage measures. Mr. Xu recovered well, was able to ambulate on the first postoperative day, and was discharged smoothly on the sixth day after surgery. To express their gratitude to the medical team, Mr. Xu and his family specially presented a banner of appreciation.