Fig. 3

Intra-operative views (legend: D = diaphragm; S = spine; PL = pulmonary ligament; RUL = right upper lobe; RML = right middle lobe). a The first aberrant feeding vessel entered the chest by penetration through the posterior diaphragm. It promptly divides into two branches once in the chest (light and dark blue arrows respectively). This vessel has been secured proximally with silk ligature and double vascular clips prior to staple-division. b The second aberrant feeding vessel (green arrow) also entered the chest by penetration through the posterior diaphragm (blue arrow = stump of first aberrant vessel). This second vessel has been secured proximally with silk ligature and double vascular clips prior to staple-division. This view gives some impression of the extensive adhesiolysis that was required around the right lung base, diaphragm and spinal area in order to expose these aberrant feeding vessels. c The third aberrant feeding vessel (yellow arrow) entered the chest along the pulmonary ligament (blue arrow = stump of first aberrant vessel; green arrow = stump of second aberrant vessel). This small third vessel has been secured proximally with double vascular clips prior to division using an ultrasonic energy device. Notice that the diaphragm has been retracted using the suction to expose the vessels. d View of the stumps of all 3 aberrant feeding vessels following division (blue arrow = first vessel; green arrow = second vessel; yellow arrow = third vessel). e View of the hilum following Uniportal right lower lobectomy, showing the stapled stumps of the inferior pulmonary vein (PV), right lower lobar pulmonary artery (PA), and right lower lobar bronchus (B)