Video-assisted thoracoscopic left S8 segmentectomy guided by pre-operative 3D reconstruction in a patient with synchronous bilateral primary lung cancer: a case report

Background: Future adoption of segmentectomy for lung cancer will likely increase with two recent randomized control trials demonstrating its oncological efficacy compared to lobectomy. It has also been used to great effect in patients with bilateral primary lung cancer to preserve lung parenchyma as these patients require more extensive lung resection compared to patients with a single primary lung cancer. However, segmentectomy, particularly complex ones which involve resection of more than one inter -segmental plane remains a more difficult operation than lobectomy. Here we report a case of synchronous bilateral primary lung cancer successfully treated with thoracoscopic left S8 segmentectomy. This case is unique in terms of utilizing a novel cloud -based platform that allows the 3D reconstruction to be easily accessible anywhere with an Internet -connected device. Case Description: A case of a 62 -year -old ex -smoker with a 30 pack -year history of smoking, hypertension, hyperlipidemia, benign prostatic hyperplasia with previous coronary artery bypass grafting and synchronous bilateral early -stage lung cancer is presented. Pre -operative 3D construction was performed in order to plan for a complex segmentectomy. A video -assisted thoracoscopic left S8 segmentectomy was performed as the first part of a two staged operation to preserve sufficient lung function in order to allow for one lung ventilation for a subsequent right thoracoscopic lower lobectomy. Post -operatively, the patient had an unremarkable recovery and managed to undergo his right thoracoscopic lower lobectomy a month later without issues. The patient remained well and disease free 8 months after his second operation. Conclusions: A novel cloud -based 3D reconstruction platform can be used to overcome many of the potential technical challenges posed by performing a complex segmentectomy such as this one. Further studies are required to determine if cloud -based platforms offer additional benefit over non -cloud -based platforms.