A lateral thoracotomy incision is made, and the thorax is entered through the sixth intercostal space for lower lobe and the fifth intercostal space for middle or upper lobe bronchiectasis. The parietal pleura is mildly or moderately thickened and attached to the lungs and chest wall. An extrapleural area is created first by blunt dissection, and the intercostal space is enlarged by using two rib spreaders for better exposure. The parietal pleura is held by two long clamps; the lung is palpated underneath, and the pleura is opened carefully with a scissor. The index finger is advanced through the hole in the parietal pleura to detach the visceral pleura gently, without injuring the lung. Subsequently, the parietal pleura is cut with the scissor to sufficiently expose the lobes. The diseased lobe becomes smaller and attaches firmly to the diaphragm and moderately to the chest wall, pericardium, aorta, and other lobe(s), depending on its anatomic location (lower or upper lobe and right or left side). In the most commonly observed location, the left lower lobe, the release of the bronchiectatic lobe starts from the surface of the descending aorta after the thoracic wall attachment is separated by blunt and sharp dissection. Generally, the aortic adventitia prevents firm invasive adhesions, making blunt separation of the lobe by hand safe. Dissection is performed by positioning the backside of the hand over the aorta while two or three fingers create a cleavage under the lobe and over the aorta. The thumb feels the fingers where the lobe attaches to the chest wall lateral to the aorta, and this attachment is released mainly by finger dissection and partly by sharp dissection to the diaphragm. The inferior surface of the lung is firmly attached to the diaphragm so that a border between the lung and diaphragm cannot be recognized easily. Therefore, dissection by the fingers from below is preferred to avoid tears in the muscle of the diaphragm. Surface bleeding is common during aortic and diaphragmatic dissection and controlled best by warm towel compressions. Releasing from the pericardium and fatty tissue is performed mainly by the energy-based ligation method or electrocautery