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The Journal of Thoracic and Cardiovascular Surgery, Vol 106, 550-553, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
MJ Mack, H Shennib, RJ Landreneau and SR Hazelrigg
Significant advances in surgical equipment, video monitoring, and
endoscopic surgical techniques have expanded the role of thoracoscopy to
include pulmonary resection. One limitation of the thoracoscopic technique
is the loss of manual palpation to identify the nodule that is either too
small or too deep beneath the pleural surface. We describe the techniques
used in 300 thoracoscopic pulmonary resections that have aided in
identification of pulmonary nodules. These techniques include careful
preoperative assessment of the computed tomogram, preoperative injection of
methylene blue, or a needle localizing system to identify the nodule.
Intraoperative techniques include instrument palpation, digital palpation,
and intraoperative ultrasonography. It should be possible to identify the
majority of pulmonary nodules at the time of thoracoscopy with these
localizing techniques. All nodules were successfully identified in our last
200 thoracoscopic resections.
ARTICLES
Techniques for localization of pulmonary nodules for thoracoscopic resection
Section of Thoracic Surgery Humana Hospital-Medical City Dallas, Tex.
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