The anterior part of the pleura over and between the veins is divided with the hook to expose and allow division of the middle lobe vein. Next, the middle lobe bronchus is exposed by blunt dissection in the hilum but sometimes the anterior part of the major fissure need to be transected. The bronchus is presented with a vessel loop and the stapler is introduced from the posterior incision ( Figure 5 ). There will now be a good view of the artery and branches to the middle lobe are exposed ( Figure 6 ), encircled and transected. The fissures are then completed beginning with stapling of the central part next to the artery via the posterior port.
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