# A combined subsegmentectomy of right S9 + 10b with single direction thoracoscopic surgery

## TL;DR

This paper introduces a new surgical technique for complex lung resections involving specific segments in the right lung.

## Contribution

The novel 'open-gate' technique is introduced for combined subsegmentectomy of right S9 and S10b.

## Key findings

- Combined subsegmentectomy of right S9 and S10b is a challenging surgical case.
- The 'open-gate' technique involves cutting the intersegmental border between S7 and S10 for better access.
- This approach is suitable for complex basal subsegmental resections.

## Abstract

Segmentectomy is widely used to treat pulmonary nodules and more functional lungs can be preserved in patients. For pulmonary nodules deep near the intersegmental border, only one single segmentectomy may not achieve adequate surgical margins, and combined subsegmental resection becomes the most suitable treatment option. Thoracoscopic combined anatomical resections involving both of right S9 and S10b are one of the most challenging cases, especially in the right chest. We previously reported a case of combined subsegmental resection of the left complex basal segment (LS9b + 10b). To our knowledge, there has been no report of combined subsegmental resection of the right S9 and S10b. Here, we aim to introduce a different technique named as “open-gate”, which means that the intersegmental border between S7 and S10 was cut open along the intersegmental septa, to deal with complex combined basal subsegmental resections.

The online version contains supplementary material available at 10.1186/s13019-024-02676-0.