,PROCEDURE PERFORMED:,  Left metastasectomy of metastatic renal cell carcinoma with additional mediastinal lymph node dissection and additional fiberoptic bronchoscopy used to confirm adequate placement of the double-lumen endotracheal tube with a tube thoracostomy, which was used to drain the left chest after the procedure.
,PROCEDURE PERFORMED : , Left metastasectomy of metastatic renal cell carcinoma with additional mediastinal lymph node dissection and additional fiberoptic bronchoscopy used to confirm adequate placement of the double - lumen endotracheal tube with a tube thoracostomy , which was used to drain the left chest after the procedure .