Uniportal video-assisted thoracoscopic left S4 anatomical segmentectomy

Superior Lingular S4 Segmentectomy

Although segmentectomy has become a routine procedure, atypical segmentectomies are less popular than their typical counterparts, probably because anatomical and surgical data are lacking. The left superior lingular S⁴ segment is considered relatively small, usually resected along with other segments. However, S⁴ segment size varies among patients, and resection of this single segment can be a valuable lung-preserving procedure in carefully selected patients with tumors located at the border of the upper division and lingular segments. We present here the anatomical and surgical features required for a methodological left S⁴ segmentectomy based on our experience and the literature.