Hillar Lymph Node Dissection

Lung hilar lymph node dissection involves systematic removal of lymphatic tissue surrounding the main pulmonary vessels and bronchi to achieve accurate staging and local disease control. After completing the lung resection and obtaining clear exposure of the hilum, the surgeon identifies the pulmonary artery, pulmonary veins, and main bronchus. The pleura is opened along the hilar structures, and nodal tissue is dissected sharply and bluntly while carefully preserving the adventitia of the vessels to avoid injury. The bronchial arteries may be divided if necessary to improve exposure. Lymph nodes are removed en bloc along with the surrounding fatty tissue, working in defined anatomical planes, and meticulous hemostasis is maintained throughout. Once the nodal packets are retrieved, the area is inspected to ensure complete clearance while protecting the phrenic, vagus, and recurrent laryngeal nerves depending on the side of the dissection.