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Updated: Jan 28, 2026

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Virtual-Assisted Lung Mapping 2.0: Preoperative Bronchoscopic Three-Dimensional Lung Mapping.

Masaaki Sato1, Kazuhiro Nagayama1, Masashi Kobayashi2

  • 1Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.

The Annals of Thoracic Surgery
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Virtual-assisted lung mapping (VAL-MAP) 2.0, combining dye marks and microcoils, safely guides sublobar lung resection. This novel technique ensures sufficient resection depth, even for deep lesions.

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Area of Science:

  • Thoracic Surgery
  • Minimally Invasive Procedures
  • Surgical Navigation

Background:

  • Sublobar lung resections require precise margin assessment.
  • Obtaining adequate resection depth, especially for deep-seated tumors, remains challenging.

Purpose of the Study:

  • To introduce and evaluate Virtual-Assisted Lung Mapping (VAL-MAP) 2.0, a novel technique for guiding sublobar lung resection.
  • To assess the safety and feasibility of VAL-MAP 2.0 in achieving sufficient resection margins.

Main Methods:

  • VAL-MAP 2.0 combines bronchoscopic multispot dye marking with deeply placed microcoils.
  • Computed tomography confirmed marking accuracy.
  • Intraoperative fluoroscopy guided microcoil identification.

Main Results:

  • Six patients underwent VAL-MAP 2.0 for wedge resection (n=5) and segmentectomy (n=1).
  • Mean lesion diameter was 10.0 ± 4.1 mm, and depth was 12.6 ± 10.3 mm.
  • 18 dye marks and 9 microcoils were placed without major complications; microcoils aided deep margin decisions.

Conclusions:

  • VAL-MAP 2.0 is safe and feasible for sublobar lung resection.
  • The technique effectively assists surgeons in obtaining adequate resection margins, particularly for deeply located lesions.