The use of minimally invasive lung segmentectomy for early-stage lung cancer is increasing. This procedure is associated with technical challenges because (1) it requires a thorough understanding of the complex segmental anatomy that frequently accompanies anomalies, and (2) it is difficult to confirm the location of small tumors during minimally invasive surgery, which makes it difficult to obtain adequate surgical margins. Herein, we summarize the published evidence and discuss key issues related to minimally invasive segmentectomy. We focus on overall efforts to overcome these challenges, including preoperative planning and simulation for segmentectomy, and intraoperative localization of small tumors.
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