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Updated: Dec 15, 2025
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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
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Preoperative lung surface localization for pulmonary wedge resection: a single-center experience
Masahiro Yanagiya1, Masaaki Sato1, Keiko Ueda2
1Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Journal of Thoracic Disease
|July 10, 2020
Summary
Preoperative lung localization aids wedge resection, but deep margins and adhesions can limit success. Virtual-assisted lung mapping shows promise in overcoming these challenges for effective lung nodule removal.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Surgical Oncology
Background:
- Preoperative lung surface localization is crucial for effective sublobar resection of small lung nodules.
- Efficacy of localization techniques can be influenced by lung conditions, tumor characteristics, and the specific method used.
Purpose of the Study:
- To evaluate the efficacy and identify limitations of preoperative lung surface localization for pulmonary wedge resection.
- To compare outcomes between computed tomography (CT)-guided percutaneous marking and virtual-assisted lung mapping (VAL-MAP).
Main Methods:
- A retrospective analysis of 215 patients undergoing curative wedge resection for malignant tumors between 1998 and 2018.
- Patients were treated using either CT-guided localization or VAL-MAP.
- Successful resection was defined as complete tumor removal with adequate margins.
Main Results:
- The overall successful resection rate was 87.6% across 153 nodules in 119 patients.
- Lower resection rates were observed for nodules with intraoperative adhesion (75.0%) and those requiring deep resection margins (>31 mm) (76.7%).
- CT-guided localization had significantly lower success rates with intraoperative adhesion (54.5%), whereas VAL-MAP success was not affected (85.7%).
Conclusions:
- Deep resection margins and intraoperative adhesion represent significant limitations for preoperative lung surface localization in curative pulmonary wedge resection.
- Virtual-assisted lung mapping appears more robust in maintaining resection efficacy in the presence of intraoperative adhesions compared to CT-guided localization.
