Figure 1.

The slip-knot method for creating the inflation-deflation line. (A) The broken line divides the intersegmental line. Each segment is deflated, and the slip-knot is made with a monofilament thread looping the target bronchus; (B) the lung is ventilated and inflated preferably with pure oxygen; (C) the slip-knot is fully pulled to ligate the bronchus with expansion of the targeted segment (segment a). The affected segment (segment a) remains inflated while the other segments (segment b, c) appear collapsed. The difference between the inflated and deflated lung parenchyma forms the demarcation line. The surgeon then dissects the parenchyma along the inflation-deflation line. Each letter a, b and c indicate the pulmonary segments in each panel.