Pulmonary lobectomy has been historically the gold standard oncologic resection for early stage non-small cell lung cancer (NSCLC). Pulmonary segmentectomy has gained popularity as technological advances and improved understanding of segmental anatomy have allowed the use of minimally invasive surgery for parenchymal sparing resections. Oncologic equivalency between segmentectomy and lobectomy remains under investigation. In this manuscript, we aim to review existing literature with regards to oncologic and functional outcomes comparing lobectomy vs. segmentectomy, and comparisons among different surgical approaches: open, traditional video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracoscopic surgery. When compared with lobectomy, segmentectomy appears to provide equivalent oncologic outcomes in appropriately selected patients, as long as adequate lymphadenectomy and negative margins are achieved. The robotic platform, with its improved visualization and use of wristed instruments may allow for a more complete lymphadenectomy during a segmental resection. The following manuscript serves as a guide for clinicians on recent literature for open, video-assisted and robotic thoracoscopic pulmonary segmentectomy.

Endobiliary stents placed for benign and malignant indications can spontaneously dislocate from the biliary system and migrate to the distal gastrointestinal tract. Stent migration can result in gastrointestinal perforation, with the most common locations in the sigmoid and distal colon, and may require surgical intervention. We describe the case of a 60-year-old female presenting with an ascending colonic perforation secondary to a dislodged plastic biliary stent placed for palliation of her gallbladder carcinoma. The patient was managed with a combined laparoendoscopic approach by a multidisciplinary team—gastroenterology performed an endoscopic stent retrieval and colorectal surgery identified the location of the perforation laparoscopically and performed colonic serosal repairs. The patient had an uneventful postoperative course and was discharged on postoperative day 4. This case demonstrates a novel minimally invasive laparoendoscopic approach at a high-volume academic center for the treatment of ascending colonic perforation secondary to biliary stent migration.

Benign vascular tumors of the mediastinum are rare, representing only 0.5% of all mediastinal masses. Given their rare presentation, they are infrequently considered in the workup of a middle mediastinal mass. We present a unique case describing the clinical, imaging and pathologic characteristics of a middle mediastinal cavernous hemangioma which was initially misdiagnosed as a bronchogenic cyst and ultimately required surgical resection with the use of veno-venous extracorporeal membrane oxygenation.