Video-assisted thoracoscopic apicoposterior segmentectomy.

Anatomic segmentectomy is a form of sublobar resection that can be both diagnostic and therapeutic in the context of an indeterminate pulmonary nodule, suspected metastasis, or small peripheral cancer.  This video tutorial demonstrates our technique for an apicoposterior anatomical segmentectomy performed by video-assisted thoracoscopy, using two ports, for resection of an undiagnosed pulmonary nodule. The steps performed by the surgical team are shown, and we pay particular attention to the recognition of vascular anatomy. To perform this type of sublobar resection, it is necessary to understand both the normal anatomy and the different variants.  This tutorial will provide a thorough grounding in the anatomy of the apicoposterior segment as well as demonstrating the optimal approach for this type of resection.