The inferior pulmonary ligament is a double layer of pleura extending from the inferior hilum to the diaphragm, anchoring the lower lobe. It contains the inferior pulmonary vein and lymphatics within its layers. Division of the ligament during pneumonectomy and lobectomy allows the remaining lung to rotate and fill the hemithorax.
Anchors the lower lobe of the lung to the mediastinum; creates a tethering force that maintains lower lobe position; allows controlled lung expansion.
The inferior pulmonary ligament is routinely divided in lower lobectomy to allow mobilisation of the lower lobe and to expose the inferior pulmonary vein. In video-assisted thoracic surgery (VATS), it is the first structure divided to enter the correct surgical plane. Failure to divide it limits lower lobe mobilisation.
Division of the inferior pulmonary ligament at the outset of lower lobectomy allows adequate lobe mobilisation and exposure of the inferior pulmonary vein for safe ligation.
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