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Methylene blue staining: a new technique for identifying intersegmental planes in anatomic segmentectomy.
Zheng Zhang1, Yongde Liao1, Bo Ai1
1Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
The Annals of Thoracic Surgery
|December 3, 2014
Summary
A new methylene blue staining technique safely and effectively identifies lung segment borders during pulmonary segmentectomy. This method aids surgeons in precisely locating intersegmental planes for improved anatomic segmentectomy procedures.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Surgical Innovation
Background:
- Pulmonary segmentectomy is increasingly used for small lung nodules.
- Identifying intersegmental planes during segmentectomy is challenging.
- A novel methylene blue staining technique was developed to address this difficulty.
Purpose of the Study:
- To describe a new methylene blue staining technique for identifying intersegmental planes in anatomic segmentectomy.
- To evaluate the feasibility and safety of this staining method.
- To facilitate accurate performance of pulmonary segmentectomy.
Main Methods:
- Anatomic segmentectomy was performed on 14 patients (10 VATS, 4 thoracotomy).
- 0.1% methylene blue (20 mL) was injected into the bronchus of target segments after vessel and bronchus division.
- Intersegmental plane boundaries were identified by the blue staining.
Main Results:
- The staining procedure took only 3 minutes.
- Clear identification of intersegmental planes was achieved on the pleural surface and within the lung parenchyma.
- All operations were completed successfully without perioperative deaths or major complications. Staining did not interfere with pathology results or cause discoloration of bodily fluids.
Conclusions:
- This study presents the first reported safe and feasible methylene blue staining method for lung segment border identification.
- The technique requires no special equipment and clearly delineates intersegmental planes.
- This method enables thoracic surgeons to accurately perform anatomic segmentectomy.
