Perioperative Identification of an Accessory Fissure of the Right Lung

Figure 1

Perioperative pictures during VATS. All photographs were taken from the camera port distally with the patient lying on his left side and the arm in 90 degrees so the respective sides of these photographs concur with apical, ventral, distal, and dorsal positions, respectively. On the ventral side, the right internal mammary artery and vein running near the sternum can be seen. Pictures (a) to (d) display the different fissures as shown with long shaft instruments. RUL: right upper lobe; RML: right middle lobe; RLL: basal segments of the right lower lobe; : apical segment of the right lower lobe. Solid white arrows: horizontal fissure; blue arrow: oblique fissure; orange solid arrow: superior accessory fissure of the right lower lobe.

(a)

(b)

(c)

(d)