(1)
IMM, Curie-Montsouris Thorax Institute, Paris, France
Electronic Supplementary Material
The online version of this chapter (doi:10.1007/978-3-319-55901-8_11) contains supplementary material, which is available to authorized users.
11.1 Anatomical Landmarks
Bronchus
The superior segmental bronchus originates opposite or slightly above the middle lobe bronchus. It lies posteriorly to the segmental artery (◘ Fig. 11.1a). It is single in most patients but can rarely arise as two separate bronchi.
Fig. 11.1
Anatomical landmarks. a B6 bronchus (lateral view), b and c A6 artery and its relation with B6 (lateral view), d double A6 artery, e V6 vein (posterior view)
Arteries
The superior segment of the right lower lobe is supplied by an artery (A6) which originates within the fissure at the same level than the basal trunk (◘ Fig. 11.1b and c). It is usually single but can be double and even triple.
Veins
The vein to the superior segment is the uppermost and smaller segmental tributary (V6) of the inferior pulmonary vein (◘ Fig. 11.1d).
11.2 Variations and Pitfalls
In rare cases, an accessory fissure separates S6 from the basilar segments (◘ Fig. 11.2a).
In some patients, the superior segmental artery originates from the ascending artery of the upper lobe (A2) or from the basal trunk (◘ Fig. 11.2b).
A6 and Ascending A2 can arise as a single trunk (◘ Fig. 11.2c). Identifying A6 before stapling the posterior part of the fissure is important to avoid injuring A2 .
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