Segmentectomy is a medical procedure that removes a portion of an organ, most commonly the liver or lungs. The remaining healthy tissue is preserved. This technique falls under a larger category of procedures known as parenchyma or organ-sparing surgeries.

Segmentectomy is a popular treatment for small or localized tumours, particularly in the early stages of lung cancer and liver disease. This procedure strikes a balance between removing the diseased tissue while maintaining organ function.

Why Segmentectomy Surgery is Performed

Segmentectomy is performed primarily for two main reasons:

1. Cancer Treatment:- Segmentectomy is often used to treat cancers that are localized, such as non-small cell lung carcinoma (NSCLC) and hepatocellular cancer. This is a good treatment for cancer patients who are in the early stages or those with poor liver or lung function.
2. Organ Preservation:- Segmentectomy is a surgical procedure that allows surgeons only to remove the affected segment of the liver or lung while leaving the healthy tissue surrounding it. This method maintains a better organ function post-operatively, which is critical for patients with limited pulmonary and hepatic reserves.
3. Minimally Invasive Method:- Segmentectomy has become a more invasive option with a quicker recovery and fewer complications.
  Segmentectomy surgery can be classified into different types of segmentectomy surgery. The procedure for segmentectomy varies depending on the organ and the location of the affected segment. Here are some of the most common:

The different types of segmentectomy surgery are crucial for tailoring treatment to patient needs.

Pulmonary Segmentectomy (Lung Segmentectomy)
The removal of one segment of the lungs is called a pulmonary segmentectomy. This procedure is used most commonly to treat lung cancers in the early stages (Stage IA), as well as benign tumors or infected cysts.

There are two types of pulmonary segmentectomy:

Superior Segmentectomy (S6):
Remove the superior segment from the lower lobe.
Tumors of the posterior lung are often affected.

Lingulectomy:

Remove the upper left lobe of the lingular segment.
When cancer is confined to the area, this procedure is often performed.

Basal Segmentectomy:

This involves the removal of one or several basal segments.
It is useful for treating small lung tumors.
Apical Segmentectomy
Remove the uppermost portion of the upper or lower lobe.
Common in cancerous lesions or TB cavities.

The following are the approaches used:

VATS Segmentectomy:

Camera-guided minimally invasive technique.
Postoperative pain is reduced and hospital stays are shorter.
Robotic Segmentectomy
Robotic arms are used to achieve precision.
Ideal for tumors that are hard to reach.

Hepatic Segmentectomy (Liver Segmentectomy)
The liver is divided anatomically into eight segments. The term segmentectomy refers to the removal of one or more segments that are affected by metastases, tumors or cysts.

There are two types of liver segmentectomy:

Patients often inquire about the types of segmentectomy surgery to determine the best options available.

Segment I Resection (Caudate Lobe Segmentectomy):
When tumors are confined to the caudate.
Due to the deep anatomical position, this is a technically challenging procedure.

Segment II/III Segmentectomy (Left Lateral Sectionectomy):

Commonly used to treat benign tumors and early liver cancers.
Laparoscopic surgery is often performed.
Segment IV Segmentectomy (Medial Segmentectomy):
Resection of the central segment of left lobe.
When tumors are near the midline of the liver, this is a good option.

Right Posterior Segmentectomy (Segments VI/VII):

The tumors in the posterior segments are often treated with this technique.
It offers excellent disease prevention and functional preservation.

The following are the approaches used:

Various types of segmentectomy surgery are available, each with specific indications.

Laparoscopic liver segmentectomy
Recovery is faster with minimally invasive surgery.
It is often used to treat tumors of the peripheral segments.
Open Liver Resection
Useful for tumors that are larger or deeper located.

It requires a longer recovery period but provides more visibility to the surgeon.

Segmentectomy surgery has many benefits

Many patients benefit from understanding the types of segmentectomy surgery before their procedure.

Organ Function Preservation: Only the diseased tissues are removed, sparing the vital parts of the lungs or liver.
Reduced Surgical Risk: This is especially beneficial to elderly patients or those with high-risk conditions.
Effective cancer control: Segmentectomy is a surgery that can be used to treat certain patients with similar success rates as lobectomy.
Faster recovery: This is especially true with minimally-invasive techniques such as VATS or laparoscopy.

Considerations and Risks

It is essential to discuss the types of segmentectomy surgery with your healthcare provider.

Segmentectomy is generally a safe procedure, but it does carry certain risks.Bleeding or infection

Resection is incomplete if the cancer has spread to a microscopic level
Recurrence of high-risk cases
Air leakage in lung surgery
Liver dysfunction after hepatic surgery (especially when cirrhosis is present)

Pre-operative imaging such as PET scans or biopsies is often used to determine suitability for the surgery.

Conclusion

Segmentectomy is an important tool for modern surgical oncology. It can also be used to preserve organs. This technique can be used to remove the diseased segment of an organ, such as the liver or lungs, while maintaining the vital functions in the remaining organ. This technique is especially useful for cancer patients in the early stages, for those with limited reserves, and for anyone who cannot undergo more radical surgery.

Segmentectomy has become a popular treatment for many conditions due to the advent of minimally invasive surgery and better diagnostic abilities. Consult a thoracic surgeon or a hepatobiliary specialist if you are considering the surgery for yourself or someone close to you. They can help determine what is best based on your diagnosis and health status, including the types of segmentectomy surgery that are applicable.