Division Of Ligament Research Articles

Lengthening Phalloplasty with Division of the Suspensory Ligament and Distally Based Fat Flaps in Penis Enlargement Operations.

Small penile size is worrying for most men and leads to poor self-esteem, anxiety, and depression. A penis can be enlarged in two ways: by increasing the length and by increasing the circumference. The purpose of this article is to present a new procedure of augmentation phalloplasty thst combines these two parts in the same operation with a new technique to fill in the dead space created by the suspensory ligament division. The lengthening of the penis is achieved with an inverted V-Y plasty followed by a division of the suspensory ligament of the penis all the way down the pubic symphysis. Two distally based fat flaps are advanced into this area to fill in the dead space. The widening of the circumference is performed with fat injections. The penile length gain postoperatively is 2 to 4 cm in the flaccid state, and the widening component with the fat grafting technique gives an approximate circumference increase of 1 cm with excellent natural results. Sexual self-esteem and functioning improvement was reported by the patients, 75 in total. Three patients returned after the operation for revision of fat injections 6 to 12 months after the operation. The literature regarding the long-term results after augmentation phalloplasty is poor, and it is difficult to compare results with other techniques. Penile enlargement, when performed for the appropriate reasons, can have a positive effect on the lives of many men. After 15 years of experience, this procedure gives very pleasing results with minimal complications.

Inferior pulmonary ligament division during left upper lobectomy causes pulmonary dysfunction.

The division of inferior pulmonary ligament (IPL) during upper lobectomy (UL) was believed to be mandatory to dilate the remaining lung sufficiently. However, the benefits, especially postoperative pulmonary function, remain controversial. This study aimed to evaluate whether IPL division leads to pulmonary dysfunction. This retrospective study included 213 patients who underwent UL between 2005 and 2018. They were categorized into an IPL division group (D group, n = 106) and a preservation group (P group, n = 107). Postoperative dead space at the lung apex, pulmonary function and complications were assessed using chest X-rays and spirometry. Changes in bronchial angle, cross-sectional area and circumference of the narrowed bronchus on the excised side were measured on three-dimensional computed tomography. There was no significant difference in the postoperative complication rate, the dead space area, forced vital capacity (FVC), or forced expiratory volume in 1 s (FEV1) between the 2 groups after right UL (FVC; P = 0.838, FEV1; P = 0.693). By contrast, after left UL pulmonary function was significantly better in the P than in the D group (FVC; P = 0.038, FEV1; P = 0.027). Changes in bronchial angle did not significantly differ between the 2 groups. The narrowed bronchus's cross-sectional area (P = 0.021) and circumference (P = 0.009) were significantly smaller in the D group than in the P group after left UL. IPL division during left UL caused postoperative pulmonary dysfunction and airflow limitation due to bronchial kinking. IPL preservation may have a beneficial impact on postoperative pulmonary function.

An experimental study on division of fracture ligament and evolution of fracture process zone in sandstone

Fracture process zone (FPZ) is an irreversible deformation and damage zone in the front of a crack tip in rock. Only a few of them experimentally focused on the size development of FPZ during the loading process. Therefore, the DIC technology was used to monitor the development of FPZ in three-point bending beam rock specimens. The far-field displacements and strains were measured during the whole loading process. By analyzing the strains, the displacements and derivative distributions in the far-field, the fractured ligament is divided into three zones: Intact Zone, Crack Propagation Zone and Fracture Process Zone (FPZ). The FPZ first appears at the 60% pre-peak load, and its initial length is 4-6 mm. The length of the FPZ increases rapidly from the 90% pre-peak load to the 95% pre-peak load, and the increased length at this period occupies 47% of its full length. The length of the FPZ increases slowly near the peak load, and it reaches a maximum (15.5 mm) at the peak load.

Elongated, finger-like ophthalmic segment aneurysms: Implications for selection of treatment modality

BackgroundMicrosurgical treatment of ophthalmic segment aneurysms often requires anterior clinoidectomy and optic nerve mobilization prior to successful clipping. ObjectiveWe hypothesize that ophthalmic segment aneurysms that are elongated and finger-like grow unconstrained, lateral to the optic nerve. We note that this avoids the need for clinoid resection and optic nerve mobilization. MethodsThree cases with up-pointing aneurysms were reviewed. Patient and aneurysm characteristics were collected. ResultsThe first two patients with elongated ophthalmic segment aneurysms were found to have aneurysms growing lateral to the optic nerve. This allowed for straightforward treatment via microsurgical clipping without anterior clinoidectomy or division of the falciform ligament. The third patient presented with distortion of the optic chiasm superiorly and medially by a giant ventral ICA aneurysm. A concomitant ophthalmic aneurysm in this patient exhibited elongated morphology, with a high-resolution MRI demonstrating the patient’s optic nerve was located inferior and medial to the ophthalmic artery aneurysm dome. This supports our hypothesis that an overriding optic nerve normally impedes vertical growth of ophthalmic segment aneurysms. ConclusionsOphthalmic segment aneurysms may acquire a round morphology when their growth is constrained superiorly by the optic nerve. Elongated ophthalmic segment aneurysms may be the result of growth lateral to the optic nerve. For these aneurysms, an anterior clinoidectomy is not required, and microsurgical clipping represents a straightforward treatment option.

Does the division of the inferior pulmonary ligament in upper lobectomy result in improved short-term clinical outcomes and long-term survival?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'Does the division of the inferior pulmonary ligament (IPL) in upper lobectomy result in improved short-term clinical outcomes and long-term survival?'. Altogether 43 papers were found using the reported search, of which 6 studies represented the best evidence to answer the clinical question, including a previous best evidence topic study, a meta-analysis and 4 retrospective cohort studies. The author, journal, date and country of publication, patient group studied, study type and relevant outcomes and results of these papers are tabulated. Most of the enrolled studies reported that there is no significant difference between the division groups and the preservation groups in terms of drainage time, drainage volume, postoperative dead space and complications. While 3 cohort studies revealed unfavoured postoperative pulmonary function in the division groups, including lung volume, forced vital capacity and forced expiratory volume in 1 s. The previous meta-analysis and a recent cohort study also found that the division of IPL might lead to increased bronchus angle change or torsion. Moreover, 2 cohort studies found that the division of IPL could not improve the long-term survival of patients undergoing upper lobectomy. Current evidence showed that dividing the IPL could not result in clinical benefits but might lead to decreased pulmonary function instead. Therefore, we recommended not dissecting the IPL routinely during upper lobectomy.

Penile augmentation by division of the suspensory ligament of the penis and autologous fat injection

To evaluate the outcome of penile augmentation (PA) surgery at one center. A retrospective review of 471 patients who underwent division of the suspensory ligament of the penis, with insertion of silicon buffer, and autologous fat injection at one unit. The following data were collected: the penile length and girth before and after the surgery, patient satisfaction and the complication rate. 471 patients were included this review over a 4 year period. The mean patient age was 35 (26-62) years; mean follow-up period was 4 (1-9) months; mean pre-operative flaccid length and girth was 9.4 (6-14) cm and 8.9 (7-11.5) cm respectively; and the mean increase in flaccid penile length and girth was 4.2 (2-8) cm and 3.9 (2.5- 7.5) cm respectively. In terms of patient-reported treatment outcome: 80% of the patients satisfied with the procedure, the main source of the dissatisfaction in the remaining patients was fat loss which occured in 94 (20%) patients and was managed by fat top up. No serious complications were encountered: 15 patients developed phimosis which resolved spontaneously except in 2 patients who needed a circumcision; 8 patients experienced the formation of a hard fat lump which was managed by needling and hyalase injections in an outpatient setting; 5 patients experienced infection of the silicon buffer which required surgical removal; 3 patients experienced discomfort from the silicon buffer which required surgical removal;7 patients had migration of some fat into the scrotum and 3 of them required surgical removal of the fat lump. None of the patients complained of downward angulation of the penis, sensory changes or erectile dysfunction. Surgical Penile enlargement is a safe, effective procedure associated with a high patient-satisfaction rates. None

The surgical outcome of buried penis surgery

Buried penis is a condition where the penis retracts. It has a significant impact on quality of life of the patient and can present with a variety of symptom. Whilst there are several causes, obesity is the most common in adults. A retrospective study on patients with buried penis operated on between 2010 and 2020. Data retrieved included presenting complaints, previous surgery, co-morbidities, surgical details and patient and surgeon satisfaction rates. A total of 141 patients were recruited with buried penis (median age 54). The presenting complaints were inability to void standing n=30, erectile dysfunction n=18, and small penis n=94. 96 patients had had previous surgery, 49 were circumcisions. The operations performed on the 141 patients were circumcision (n=40), scrotoplasty (n=35), V-Y plasty(n=11), skin grafting (n=34), suprapubic fat pad excision(n=77), abdominoplasty (n=25), penile prosthesis (n=14), and division of suspensory ligament (n=24). The post-operative length of stay was 0-52 days. There were 27 complications; infections (n=15), dehiscence (n=5), haematomas (n=2)The mean follow up was 506 days (range 0-4313 days) with a surgical satisfaction rate of 87% and patient satisfaction of 79% (p=0.021). Of note the highest dissatisfaction occurred in patients having circumcision and/or suprapubic fat pad removal. Buried penis is a complex condition with patients likely requiring a combination of surgical techniques. Circumcision alone usually does not treat the problem and may make things worse. A prolonged hospital stay with significant wound complications may occur but the majority of patients are happy with the final outcome. No conflict of interest to declare.

Robotic Spleen-Preserving Distal Pancreatectomy with Preservation of Splenic Vessels Using the Gastrohepatic Ligament Approach: The Superior Window Approach in the Kimura Technique

Minimally invasive spleen-preserving distal pancreatectomy (SPDP) is technically challenging, and only a few reports have described surgical approaches for minimally invasive SPDP. This report demonstrates our novel gastrohepatic ligament approach in robotic SPDP with preservation of the splenic vessels (the superior window approach in the Kimura technique). Our gastrohepatic ligament approach for robotic SPDP included four steps. First, the gastrohepatic ligament was divided extensively, and the pancreas was confirmed (step 1). In this step, we did not lift the stomach, nor did we divide the gastrocolic ligament. Next, the superior and inferior borders of the pancreas were dissected, and the tunneling of the pancreas on the superior mesenteric vein was performed (step 2). Following the division of the pancreas (step 3), the pancreatic body and tail were dissected from the medial to the lateral side with preservation of the splenic vessels (step 4). Using this approach, the pancreas can be directly accessed via the gastrohepatic ligament route and dissected without division of the gastrocolic ligament or retraction of the stomach. The present approach for robotic SPDP preserves splenic vessels, facilitating easy access to the pancreas with minimal dissection, and may be optional in selected patients, including those with low body mass index.

A case series of rare pathologies of the aorta and the aortic arch in adolescents and younger adults: Transfer of experience for an individualized approach.

ObjectiveWhile aneurysm of the aortic root, interrupted aortic arch, and aortic coarctation are the most frequent aortic diseases in adolescents and younger adults, there are a number of rare pathologies of the thoracic aorta that need individualized treatment.PatientsWe present a small case series of unusual aortic pathologies in patients presenting with a broad spectrum of symptoms: tiredness, dysphagia, dyspnea, arterial hypertension, renal failure, and claudication. (1). Segmental agenesia of the descending aorta. (2). Balanced double aortic arch with complete vascular ring. (3). Right descending aortic arch, left lusorian artery with Kommerell diverticulum. (4). Large patent ductus (2.5 cm) and ventricular septal defect. (5). Aneurysm of the aortic arch in the presence of tuberous sclerosis. (6). Pseudo-aneurysm of the proximal descending aorta following coarctation patch plasty. (7). Supravalvular aortic stenosis combined with severe aortic valve stenosis. (8). Pseudo-aneurysm following ascendens-to-descendens bypass because of recurrent coarctation. (9). Takayasu arteriitis with severe stenosis in the thoraco-abdominal aorta.ResultsThe following procedures were performed, using individualized cardiopulmonary bypass, canulation and cerebral protection strategies. (1). Ascending to supraceliac extra-anatomic bypass. (2). Division of the ductus ligament and of the anterior aortic arch distally to the left subclavian artery. (3). Excision of the Kommerell diverticulum and translocation of the left subclavian artery. (4). Patch closure of the aorto-pulmonary window (patent ductus) and closure of the ventricular septal defect. (5). Complete aortic arch replacement combined with debranching of the supra-aortic vessels. (6). Graft interposition of the proximal descending aorta. (7). Enlargement of the ascending aorta and aortic valve replacement. (8). Exclusion of the pseudo-aneurysm, end-to-side graft interposition. (9). Ascending aorta to infrarenal aorta or ascending to bi-iliac artery bypass (planned). All patients were operated on without operative mortality. One patient died in-hospital from pulmonary complications one week after surgery. One patient is still awaiting surgery. All other patients recovered very well from the operation and did not show any residual symptoms.ConclusionRare pathologies of the thoracic aorta in younger patients may cause a broad spectrum of unusual symptoms; in some of them, diagnosis is delayed. Cross-sectional imaging is mandatory for optimal operative planning Surgical treatment can be performed with very satisfying results. The prognosis of these patients is usually favorable following surgery.

Ectopic gall bladder

Various congenital anomalies of the gall bladder related to its location, number, shape and size have been described in the literature but the most common among them is the variation in its position. The other anomalies are not common. An ectopic gallbladder is a rare congenital anomaly of its position, which is usually missed on a preoperative workup and detected mostly during surgery. The entity is important because it causes difficulty during the procedure, and a knowledge can prevent serious post-operative complications including bile duct injury. Safe operating techniques including careful dissection of the gall bladder from the cystic plate, and division and lifting of the falciform ligament, reduces the chances of post-operative complications.

Laparoscopic Ovarian Transposition with Extraperitonealization of the Infundibulopelvic Ligament for Cervical Cancer in Ten Steps

Preservation of ovarian function is important for the physical and psychosexual well-being of young patients with cancer. Patients with pelvic malignancies such as cervical or rectal cancer planned for radiotherapy may benefit from ovarian transposition with the aim of moving the ovaries outside the radiation field.1 Different surgical techniques have been reported previously.2,3 With the present video, we aim to standardize the surgical technique of laparoscopic ovarian transposition in ten steps. We present the case of a 30-year-old nulliparous woman diagnosed with grade 3 squamous cell cervical carcinoma having a largest tumor diameter of 41 mm on magnetic resonance imaging (MRI) scan. The tumor was staged as FIGO 2018 stage IIIC1r with a common iliac lymphadenopathy reported on both MRI and positron emission tomography (PET)/computed tomography (CT) scan. The multidisciplinary team recommended exclusive chemoradiation extended to paraaortic area. The patient underwent laparoscopic bilateral salpingectomy and bilateral ovarian transposition with extraperitonealization of the infundibulopelvic ligament. The procedure was divided into the following ten steps: division of uteroovarian ligament, incision of lateral pelvic peritoneum, identification of ureter, incision of medial pelvic peritoneum, skeletonization of the infundibulopelvic ligament, retroperitoneal tunnel in paracolic gutter, creating the window (as high as possible), mobilization of the ovary without torsion, intraperitonealization of the ovary, and fix ovary with clips (Fig. 1). Surgical time was 30 min, with minimal estimated blood loss. No intra- or postoperative complication was recorded. The patient started radiotherapy 14 days after the procedure. In conclusion, we showed that laparoscopic ovarian transposition in cervical cancer before radiotherapy can be standardized in ten steps with encouraging perioperative results, making it an easily reproducible procedure. Ovarian function is reported to be preserved in 62–65% of cases undergoing ovarian transposition and radiation therapy.4,5Fig. 1Laparoscopic view of right ovary transposed below the liver edge after extraperitonealization of the infudibulopelvic ligament

Laparoscopic surgical treatment of median arcuate ligament syndrome with the retrograde division technique: a case report

Median arcuate ligament syndrome is a rare entity. This clinical condition develops by compression of the root of a celiac artery with the median arcuate ligament. The typical triad of this syndrome is the following; abdominal discomfort and pain, especially after a meal, and weight loss. In diagnosis, other causes should be ruled out and compression must be demonstrated by any type of imaging method. The main principle of treatment is cutting down the median arcuate ligament. A 54-year-old woman presented with untreatable recurrent abdominal pain and was diagnosed with median arcuate ligament syndrome by imaging with angiographic computed tomography. This patient was operated on. We performed laparoscopic division of median arcuate ligament with the retrograde surgical dissection technique. The patient was discharged from the hospital without any complaint on the third day after surgery. She was still symptom-free after 12 months. The laparoscopic retrograde dissection approach is a safe and feasible treatment modality for median arcuate ligament syndrome.

Round Ligament Management in Female Patients Undergoing Inguinal Hernia Repair: Should We Divide or Preserve?

Although inguinal hernia repair in female patients is less common than in male patients, it remains a frequent procedure. The decision to divide or preserve the round ligament has largely been left to surgeon preference, but little data exists about its impact on outcomes. This study aimed to describe current practices for round ligament management and identify the impact of division on surgical and patient-reported outcomes. The 2013 to 2021 Abdominal Core Health Quality Collaborative database was queried for all female patients undergoing inguinal hernia repair with 30-day patient-reported outcome data available. Comparison groups were created based on round ligament management: round ligament division (RLD) or round ligament preservation (RLP). We identified 1365 female patients who underwent open (36.3%), laparoscopic (34.5%), or robotic (28.2%) repair. Most were non-recurrent (93%) and unilateral (82.6%). The round ligament was divided in 868 (63.6%) and preserved in 497 (36.4%) cases. There were no significant differences in overall complications (RLD 7.1%, RLP 5.2%, p = 0.17), reoperation (RLD 0.5%, RLP 0.2%, p = 0.4), or recurrence (RLD 0.1%, RLP 0.4%, p = 0.28). Mean European Registry for Abdominal Wall Hernias quality of life summary scores were not significantly different at 30 days (RLD 27.2, RLP 27.8) or 6 months (RLD 12.8, RLP 17.1). However, a significant difference was found in terms of mean pain-specific scores at 6 months, with lower pain scores in the RLD group (3 vs 4.7, p < 0.01), which persisted on multivariable analysis (p = 0.02). RLD is a common practice and is not associated with increased complications or recurrence. Although there is some evidence that RLD may result in decreased pain at 6 months, this must be balanced with potential functional complications of division that are not fully studied in this paper.

Penis Enlargement by Penile Suspensory Ligament Division with Cross-Plasty of the Skin.

To demonstrate modified technique of penile lengthening. We have reviewed 30 patients who underwent surgery with the use of the proposed "cross-method" and also compared with 35 patients who had surgery with the division of the suspensory ligament performed with the use of V-Y plasty method. We have achieved better enlargement and SEAR (self-esteem and relationship) scores with the "cross-method" compared to V-Y plasty. The cross-method is a simple alternative technique for penile lengthening that can be performed safely in order to treat small penis syndrome and obtain better results.

Laparoscopic treatment of symptomatic Dunbar syndrome: a case report.

Introduction and aim of the studyDunbar syndrome is a rare disorder due to the external compression of the celiac trunk by the median arcuate ligament. The symptoms include abdominal pain, nausea and vomiting with a significative reduction in patients' quality of life. Laparoscopy has proven to be a safe procedure. The aim of this study is to present a case of Dunbar syndrome undergoing laparoscopic surgery.Case presentationA 40-year-old male patient presented at Emergency Room with upper abdominal pain and dyspepsia, related to food intake. A selective arteriography of the celiac trunk revealed stenosis due to compression of the celiac artery.Clinical discussionLaparoscopic decompression of the celiac trunk by the median arcuate ligament was performed. Postoperative course was uneventful and the patient was discharged on the 5th postoperative day.ConclusionMinimally invasive surgical division of the arcuate ligament is feasible and safe and it can restore patients' quality of life.

Severe Post-prandial Pain: A Case Report

Median arcuate ligament syndrome (MALS) is a rare cause of post-prandial abdominal pain due to compression of the celiac artery and celiac plexus. Associated symptoms include nausea, vomiting, diarrhea, and weight loss. The incidence of radiologic compression of the celiac axis is reported to be between 10% and 24%; however, symptomatic compression is noted to be found in about half of the population. MALS is considered a diagnosis of exclusion due to its tendency to present with nonspecific symptoms that mimic other common causes of abdominal pain. Radiologic evidence from angiography with breathing maneuvers is the gold standard for diagnosis. Surgical division of the median arcuate ligament to decompress the celiac artery is an effective treatment proving to provide up to 60-70% of symptomatic relief.

Supraceliac aortic cross-clamping to control bleeding from the celiac axis during pancreatic surgery: a case report

BackgroundIntraoperative bleeding from the celiac axis (CA) can occur during pancreatic surgery, and appropriate management is essential to avoid critical complications. Here, we have reported a case that was managed with supraceliac aortic cross-clamping (SAC) for arterial bleeding from the CA during pancreatic surgery.Case presentationA 70-year-old man was diagnosed with pancreatic cancer located in the pancreatic head and body. Preoperative computed tomography showed a stricture at the root of the CA, which may have been caused by a median arcuate ligament. Pancreaticoduodenectomy with division of the median arcuate ligament was scheduled. Uncontrollable bleeding from the root of the CA was observed during surgery. The bleeding was controlled by performing SAC, and a defect in the CA was confirmed. Arterial wall repair was successfully performed under temporal blood control using SAC. The aortic clamp time was 2 min and 51 s, and the intraoperative blood loss was 480 ml.ConclusionsAlthough SAC is primarily a procedure for ruptured abdominal aortic aneurysm, it can be useful for the management of CA injuries during pancreatic surgery.

Robotic versus laparoscopic median arcuate ligament (MAL) release: a retrospective comparative study.

Multiple retrospective studies have demonstrated the safety and feasibility of laparoscopic median arcuate ligament division with celiac neurolysis for the definitive management of median arcuate ligament syndrome (MALS). This study queries the clinical equipoise of robotic (RMALR) versus laparoscopic MAL release (LMALR) at a high-volume center. A retrospective analysis of consecutive 26 RMALR and 24 LMALR between March 2018 and August 2019 by a single surgeon at a quaternary academic institution was completed. Primary endpoint was postoperative decrease in celiac trunk expiratory peak systolic velocities (PSVs) measured by mesenteric duplex ultrasonography. Secondary outcomes included reported improvement in MALS-related clinical symptoms, distribution of first assistant seniority level, and involvement of second assistants in RMALR versus LMALR. Mean operative times for LMALR and RMALR were 86 and 134min, respectively (p < 0.0001). There were no open conversions and mean length of hospital stay was 1day for both cohorts. Both groups provided an equally effective decrease in postoperative peak systolic velocities (PSVs) (LMALR p = 0.0011; RMALR p = 0.0022; LMALR vs. RMALR p = 0.7772). While RMALR had significantly higher reduction of chronic abdominal pain postoperatively, there were no significant differences in other postoperative symptom relief between groups. However, RMALR patients reported significant relief of postprandial abdominal pain (p < 0.0001) and chronic nausea (p = 0.0002). RMALR had significantly more junior first assistants (p = 0.0001) and less frequently required second assistants compared to LMALR (p = 0.0381). In this study comparing RMALR to LMALR, postoperative chronic abdominal pain relief was significantly less in the former while other outcomes were equivalent. In comparison with LMALR, RMALR cases were associated with more junior first assistants, fewer second assistants, and longer operative times. Both approaches are safe and feasible for well-selected patients in experienced centers.

Does Recurrence of Carpal Tunnel Syndrome (CTS) after Complete Division of the Transverse Ligament Really Exist?

The aim of this study was to evaluate whether recurrent carpal tunnel syndrome (CTS) after complete and sufficient division of the transverse ligament really exists. Another goal was to analyze the underlying reasons for recurrent CTS operated on in our department. Over an observation period of eleven years, 156 patients underwent surgical intervention due to CTS. The records of each patient were analyzed with respect to baseline data (age, gender, affected hand), as were clinical signs and symptoms pre- and postoperatively. To assess long-term results, standardized telephone interviews were performed using a structured questionnaire in which the patients were questioned about persisting symptoms, if any. Of the 156 patients, 128 underwent first surgical intervention due to CTS in our department. In long-term follow-up, two-thirds of these patients had no symptoms at all; one-third of the patients described mild persisting numbness. None of the patients experienced a recurrence of CTS. The 28 patients who received their first operation outside of our department were operated on for recurrent CTS. The cause of recurrence was incomplete division of the distal part of the transverse carpal ligament in all cases. The results suggest that recurrent CTS after complete and sufficient division of the transverse ligament is very unlikely.

Inferior Pulmonary Ligament Division May Be Unnecessary during Left Upper Lobectomy: Effects on Lung Volume, Bronchial Angle and Bronchial Tortuosity.

The benefits of dissecting inferior pulmonary ligament (IPL) during upper lobectomy using video-assisted thoracoscopic surgery (VATS) for early-stage lung cancer remains controversial. This study evaluates the effect of IPL dissection by comparing the lung volume, bronchial angle, and bronchial tortuosity of the left lower lobe (LLL) during VATS upper lobectomy. Medical records of all patients who underwent VATS left upper lobectomy for early-stage lung cancer were evaluated. Patients were divided into group P (preservation) and group D (dissection). Pre- and post-surgery lung volumes, bronchial angles (angle 1: axial angulation; angle 2: vertical angulation), and bronchial tortuosity (curvature index of the left main bronchus) were measured using computed tomography images for comparison. Forty patients were included in each group. Patient characteristics such as age, gender, body mass index, and smoking status, and preoperative lung volume, bronchial angles, and tortuosity were not significantly different between the two groups, and there was no statistically significant difference in the axial and vertical angulations; however, the change in pre- and postoperative bronchial tortuosity (0.03 ± 0.03 vs. 0.06 ± 0.03) and lung volume (−558.1 ± 410.0 mL vs. −736.3 ± 382.7 mL) showed a significant difference (p < 0.001 and p = 0.04, respectively). Preservation of IPLs during left upper lobectomy may be beneficial for LLL expansion and induces less movement and positional change in the left main bronchus.