Robotic Surgery for Intralobar Sequestration (Left S6+10 Segmentectomy)

Pulmonary sequestration is a condition in which a segment or lobe of dysplastic lung tissue exists with no communication with the rest of the tracheobronchial tree and receives an anomalous systemic vascular supply, separate from the rest of the lung. It is, thus, a nonfunctional tissue.

There are 2 types: intralobar and extralobar. Intralobar sequestration is characterised by its presence within the visceral pleura of the functioning lung. It is more common in the left lower lobe. Approximately two-thirds of intralobar sequestrations are found in the posterior basal segment of the left lower lobe. It is more common and has a reported incidence of 75% to 86% among all cases of sequestration.

This video shows a case of intralobar sequestration involving both the superior segment (S6) and the posterior basal (S10) segment of the left lower lobe. We used the Da Vinci Xi robotic surgical system to perform this surgery minimally invasively. The video magnification and fine agile instrumentation of the robotic system was ideal for this type of surgery.

The patient made an uncomplicated recovery and was discharged how 4 days after surgery. When reviewed 2 weeks after surgery she had already returned to full activities and reported being pain-free and feeling well.

The surgery was recorded using the cloud based Parallel Nexus platform.

References: 1. Corbett HJ, Humphrey GM. Pulmonary sequestration. Paediatr Respir Rev. 2004 Mar;5(1):59-68.  2. Pryce DM. Lower accessory pulmonary artery with intralobar sequestration of lung; a report of seven cases. J Pathol Bacteriol. 1946 Jul;58(3):457-67.