胸腔镜肺段切除术解剖基础.pptx

胸腔镜肺段切除术解剖基础命名记忆学习交流Pulmonary Segments 左上肺 左下肺 右上肺 右中肺 右下肺左上肺解剖左上肺支气管解剖左上肺动脉解剖左上肺静脉解剖左上肺解剖图支气管左上肺右上肺左下肺右下肺动脉左上肺右上肺左下肺右下肺静脉左上肺右上肺左下肺右下肺段间的判断段间裂膨胀萎陷法解剖基础左上肺的解剖左上肺解剖V1+2A1残端V3A3Med .A4+5V4+5B3B1+2B4B5右上肺的解剖右下肺的解剖左下肺的解剖难点：变异肺段变异For example: 左上肺前段支气管B3a, B3b+c 90%others 10%左上肺前段支气管 B3左上肺前段支气管 B3左上肺前段支气管 B3肺段变异For example: 左上肺尖后段支气管B1+2a+b, B1+2c 65%B1+2a, B1+2b+c others 35%左上肺固有段支气管 B1+2左上肺尖后段支气管 B1+2左上肺尖后段支气管 B1+2肺段变异照片Artery variationUniportal VATS right lower lobectomyA2upper lobeA6A4Lower lobemiddle lobeA5Artery variationUniportal VATS right lower lobectomyA6 stumpupper lobeA2Lower lobemiddle lobeVein variationUniportal VATS left upper lobectomyLULBLLLBV1+2+3 stumpV4+5 stump IPVVein variationIPVV6V2Bronchus variation in LLL After left upper lobectomyBronchusstumpBronchusstumpOpen surgery – Left upper lobectomy术前三维重建常用软件1. Mimicsfor Windows2. Osirixfor Mac OSwith Lite Version3. DeepInsightExample 1a pure 8-mm GGO nodule within the Left lower lobeExample 1Example 1 : LS6 + S*LS6 + S*Tumor ( between LS6 LS* )S6V6bS*TumorExample 1 : LS6 + S*Example 2a pure 8-mm GGO nodule within the right lower lobeExample 2Example 2 : RS6 + S8aTumorRS6 + S8aTumor ( between RS6 RS8a )A6V6bA8a