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Thoracoscopic wedge lung resection using virtual-assisted lung mapping.

Masaaki Sato1, Akihiro Aoyama2, Tetsu Yamada2

  • 1Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan satomasa@kuhp.kyoto-u.ac.jp.

Asian Cardiovascular & Thoracic Annals
|June 15, 2014
PubMed
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Virtual-assisted lung mapping (VALM) enables precise tumor identification and adequate resection margins during thoracoscopic lung wedge resection. This technique, utilizing virtual images for multiple dye markings, proved effective in identifying lung tumors and ensuring satisfactory outcomes.

Area of Science:

  • Thoracic Surgery
  • Pulmonology
  • Medical Imaging

Background:

  • Virtual-assisted lung mapping (VALM) is an innovative bronchoscopic technique for preoperative lung marking.
  • It uses virtual images to create multiple dye markings concurrently.
  • This study evaluates VALM's use in lung wedge resections.

Purpose of the Study:

  • To analyze the indications for VALM.
  • To examine the mapping design strategies employed.
  • To assess the outcomes of lung wedge resections using VALM.

Main Methods:

  • A prospective data collection was performed for VALM in 35 patients (59 lesions) undergoing thoracoscopic lung wedge resection from August 2012 to October 2013.
  • Mapping designs were retrospectively analyzed.
Keywords:
BronchoscopyFluoroscopyLung neoplasmsStaining and labelingThoracic surgeryVideo-assisted thoracic surgery (VATS)

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  • VALM was used to guide 50 wedge resections with 107 markings.

    • Main Results:

    • VALM was applied to resect suspected primary lung cancers (21 lesions) and metastatic lung tumors (38 lesions).
    • The most common mapping designs involved 2 or 3 markings to identify tumors and secure resection margins.
    • Complementary techniques using anatomical landmarks and auxiliary lines were used when ideal marking spots were unavailable due to bronchial anatomy.

    Conclusions:

    • Multiple markings in VALM effectively facilitate tumor identification and ensure sufficient resection margins.
    • Special techniques involving anatomical landmarks and auxiliary lines are valuable adjuncts when bronchial anatomy poses challenges for ideal marking placement.