StayCurrentMD · Mentoring+Technology+Progression-HD
Video4 min·Published May 2026

Mentoring+Technology+Progression-HD

With Dr. Steve Rothenberg

Chapter 1 of 6 · Surgical Management

Vessel clipping

Vessel dissection and clip placement technique near diaphragm

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More about this diagnosis

Bronchogenic cyst
What the experts said13 expert statements
Dividing tissue will free up the lower lobe and help pull it away to maximize length
ClinicalDr. Steve Rothenberg
Clips should be placed as close to the diaphragm as possible while maximizing vessel length
ClinicalDr. Steve Rothenberg
Using more of the instrument tip allows better visualization of the vessel itself
ClinicalDr. Steve Rothenberg
Standard technique is to measure 10 centimeters up from the pylorus using 10 centimeter silk
ClinicalTodd
The G-tube location typically corresponds to approximately 10 centimeters from the pylorus
ClinicalTodd
After placing a suture loop, grasping the peritoneum with Maryland forceps and pulling up on the loop can reposition the suture
ClinicalDr. Steve Rothenberg
The differential diagnosis for the cystic lesion includes whether it represents two elements or a bronchogenic cyst
ClinicalBob
A superior segment resection is feasible based on the anatomical findings
ClinicalDr. Steve Rothenberg
Unroofing the top of the cyst and carrying the dissection back allows visualization of how it separates from upper lobe vessels
ClinicalDr. Steve Rothenberg
The superior segment artery is expected to be located within the dissection plane near the cyst
ClinicalDr. Steve Rothenberg
Lymph nodes in the area need to be removed to facilitate the dissection
ClinicalDr. Steve Rothenberg
After taking the artery, a dissection plane will become apparent
ClinicalDr. Steve Rothenberg
Vessel control can be achieved with either an endo-loop or clips
ClinicalDr. Steve Rothenberg