An optimal thoracoscopic segmentectomy approach - Combined ultra-high-definition 4K endovision systems with “no-waiting” technique in S8-9 complex segmentectomy

Sep 24, 2026

Uploaded by Hazel

Thoracoscopic segmentectomy may replace lobectomy for small-size lung cancer, but optimal outcomes require precise identification of the pulmonary intersegmental plane. Ultra-high-definition 4K endovision systems have been proposed to improve depth perception using secondary visual cues, while the “no-waiting” procedure is an alternative method for plane identification. This case report evaluates combined use of both approaches during thoracoscopic S8–S9 complex segmentectomy.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

AccessFree to download

Abstract

Introduction

Case Presentations

Patient information

Surgical methods

DOI: 10.1111/1759-7714.14833 CASE REPOR T An optimal thoracoscopic segmentectomy approach: Combined ultra-high-definition 4K endovision systems with “no-waiting”technique in S8-9 complex segmentectomy Mingqiang Liang 1,2 | Liang Wang 3 | Jiabin Gao 3 | Zhiliang Duan 3 | Jinhai Xu 3 | Yifang Wang 3 | Shixin Li 3 | Bowen Wang 3 | Chun Chen 1,2 1Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China 2Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China 3Department of Thoracic Surgery, Guyuan People’s Hospital, Guyuan, China Correspondence Chun Chen, Department of Thoracic Surgery, Fujian Medical University Union Hospital, \#29 Xinquan Road, Fuzhou, Fujian, 350001, China. Email: [chenchun0209@fjmu.edu.cn](chenchun0209@fjmu.edu.cn) Bowen Wang, Department of Thoracic Surgery, Guyuan People’s Hospital, Jiulong Road, Guyuan, Ningxia, 756000, China. [Email:](Email: wbwzh68@163.com)[ wbwzh68@163.com](Email: wbwzh68@163.com) Funding information Fujian Provincial Health Technology Project, Grant/Award Number: 2020CXA023; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University Construction, Grant/Award Number: No.2019-67 Abstract Thoracoscopic segmentectomy might be an alternative to lobectomy for small size lung cancer. Precise identification of the pulmonary intersegmental plane was needed for an optimal segmentectomy. Recently,(1) the ultra-high-definition 4K systems had claimed to overcome the lack of depth perception by secondary visual cues; (2) the no-waiting procedure was induced as an alternative and optimized method for identifying the plane. It was unclear whether combined ultra-high-definition 4K endovision systems with “no-waiting” technique in thoracoscopic segmentectomy could achieve an excellent result. A 68-year-old female patient was admitted into our hospital for occasional pulmonary nodule during her routine physical examination. The nodule is located between S8 and S9 segment, and was suspected to be an early-stage lung cancer. She underwent a thoracoscopic S89 complex segmentectomy using ultra-highdefinition 4K endovision systems and “no-waiting” surgical technique. The intersegmental plane was clearly detected and easily treated by the endoscopic linear cutting staplers. The patient recovered well and was discharged without complications. Combining ultra-high-definition 4K endovision systems with “no-waiting” technique seems to be an optimal thoracoscopic segmentectomy approach for the management of lung cancers. KEYW ORD S “no-waiting” technique, 4K endovision systems, case report, pulmonary nodules, segmentectomy INTRODUCTION There has been a noted increase in the number of small lung nodules and non-solid lung cancers being identified because of the advances in computed tomography (CT) technology over the last decade. The National Comprehensive Cancer Network guidelines recommend that segmentectomy can be an alternative to lobectomy in terms of intent to cure early-stage non–small cell lung cancer (NSCLC) . 1,2 Precise identification of the pulmonary intersegmental plane is needed for optimal segmentectomy. Several techniques have been proposed for the identification and treatment of the intersegmental planes.3–5 Recently, the no-waiting procedure, as described by Wang et al. ,6 was an alternative and optimized method for identifying the plane of the lung segment. The ultra-high-definition 4K systems (4K systems), which has four times the pixels and double the resolution (3840 􀀁 2160 pixels) of standard two-dimensional highdefinition systems, claimed to overcome the lack of depth perception by secondary visual cues.7,8 This has been shown in an experimental study to be comparable to three-dimensional (3D) systems.9 The 4K systems were applied in several surgeries, including proctectomy,10 gastrectomy,11 and cholecystectomy.12 It was thought

FAQs

Why is precise intersegmental plane identification important in segmentectomy?

Precise identification of the pulmonary intersegmental plane is required to achieve an optimal thoracoscopic segmentectomy.

What was the role of ultra-high-definition 4K endovision systems in this case?

The 4K system was used to help overcome limited depth perception by using secondary visual cues during surgery.

How does the “no-waiting” technique contribute to the procedure?

The “no-waiting” procedure is described as an alternative and optimized method to identify the lung segment intersegmental plane for treatment.

Sep 24, 2026

Uploaded by Hazel