Individual ligation technique for lower lobe lobectomy.

The classic description of the individual ligation technique for lower lobectomy was published in 1940. Doctor Brian Blades and Dr Edward Kent clearly described the anatomy of the bronchus, pulmonary artery, and vein to both the right and left lower lobes based on their dissection of 83 fresh cadaver lungs. They also provided a detailed description of their recommended technique for dissection, transection, and closure of each major structure. This was an important departure from the previously described mass ligation techniques. This cadaver experience was effectively transferred to the operating room. Kent and Blades reported on 18 patients who underwent lower lobectomy without mortality or the dreaded complication of "putrid empyema." They high-lighted several basic thoracic surgical principles necessary for successful lower lobectomy that are as valid today as they were then. This landmark report provided the impetus for thoracic surgeons to accept lobectomy as a safe and standard anatomical resection.