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Updated: Jan 5, 2026
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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
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Precise sublobar lung resection for small pulmonary nodules: localization and beyond.
1Department of Thoracic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. satom-sur@h.u-tokyo.ac.jp.
General Thoracic and Cardiovascular Surgery
|October 27, 2019
Summary
Accurate localization of small lung nodules is crucial for minimally invasive sublobar resections. New virtual-assisted lung mapping (VAL-MAP) techniques improve tumor identification and margin assessment, enhancing surgical outcomes.
Area of Science:
- Thoracic Surgery
- Pulmonology
- Medical Imaging
Background:
- Early-stage lung cancer detection via CT screening necessitates precise surgical localization for sublobar resections.
- Intraoperative identification of small nodules is challenging, driving the need for advanced localization techniques.
- Current methods like CT-guided hookwire placement carry risks such as air embolism.
Purpose of the Study:
- To review and discuss evolving techniques for localizing small pulmonary nodules during minimally invasive lung cancer surgery.
- To highlight the development and advantages of virtual-assisted lung mapping (VAL-MAP) for precise tumor resection and margin control.
Main Methods:
- Review of various percutaneous and bronchoscopic localization techniques, including CT-guided hookwire placement and electromagnetic navigation bronchoscopy.
- Detailed explanation of Virtual-Assisted Lung Mapping (VAL-MAP) and its advancement to VAL-MAP 2.0, incorporating dye marking and microcoil placement.
- Discussion of intraoperative imaging modalities like fluoroscopy and cone-beam CT.
Main Results:
- Bronchoscopic localization, particularly with electromagnetic navigation, is increasingly utilized.
- VAL-MAP provides 2D geometric information, while VAL-MAP 2.0 enables 3D lung mapping for improved margin assessment.
- These advanced mapping techniques facilitate intraoperative navigation and enhance the precision of sublobar resections.
Conclusions:
- Advanced localization and lung mapping techniques are essential for successful sublobar lung resections in early-stage lung cancer.
- VAL-MAP 2.0 offers a significant improvement for ensuring adequate resection margins and preventing local recurrence.
- Future developments, including augmented reality, promise further enhancements in lung resection accuracy and convenience.
