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Related Experiment Video

Updated: Nov 5, 2025

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
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[Thoracoscopic Right S6b+S8a+S9a Combined Subsegmentectomy for Small-sized Lung Cancer].

Yutaka Hirano1, Kouta Araki, Kazuhiro Washio

  • 1Department of General Thoracic Surgery, Chugoku Central Hospital, Fukuyama, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|May 13, 2021
PubMed
Summary

A minimally invasive combined subsegmentectomy effectively removed early-stage lung cancer. Virtual-assisted lung mapping (VAL-MAP) with indocyanine green (ICG) precisely guided the sublobar resection, ensuring accurate tumor removal.

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Medical Imaging

Background:

  • Early-stage lung cancer diagnosis and treatment present challenges for precise surgical resection.
  • Sublobar resections are increasingly favored for small lung nodules to preserve lung function.
  • Accurate identification of tumor location and surgical margins is critical for successful outcomes.

Observation:

  • A 76-year-old male presented with a cough, and a 20 mm part-solid nodule in the right lower lobe was detected via computed tomography (CT).
  • The nodule's location (S8a) adjacent to other segments (S6b, S9a) necessitated a complex resection strategy.
  • Virtual-assisted lung mapping (VAL-MAP) using indocyanine green (ICG) was employed for preoperative marking and intraoperative guidance.

Findings:

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  • Thoracoscopic right S 6b+S 8a+S 9a combined subsegmentectomy was successfully performed.
  • Intraoperative identification of the intersegmental plane was achieved using intravenous ICG, confirming the VAL-MAP guidance.
  • Pathological diagnosis revealed invasive mucinous adenocarcinoma with no lymph node metastasis.

    • Implications:

    • Combined subsegmentectomy is a viable and effective surgical option for treating small, early-stage lung cancers in specific locations.
    • VAL-MAP with ICG facilitates precise localization and resection of lung nodules, potentially improving surgical accuracy and reducing invasiveness.
    • This approach aids in lung cancer management by enabling targeted resection while preserving healthy lung tissue.