Thoracoscopic precision excision technique for small non-palpable lesions using radiofrequency identification lung...

Area of Science:

• Thoracic Surgery
• Minimally Invasive Procedures
• Diagnostic Imaging

Background:

• Conventional resection of small, non-palpable lung nodules, especially those deep or hilar-adjacent, poses challenges for stapler-based techniques.
• Segmentectomy, while effective, involves extensive hilar dissection, potentially leading to adhesions and limiting future surgical interventions.

Purpose of the Study:

• To introduce and evaluate a thoracoscopic precision excision technique for small pulmonary nodules using a radio frequency identification (RFID) marking system.
• To enable real-time localization and precise excision of nodules in challenging locations while minimizing parenchymal resection and preserving lung function.

Main Methods:

• Preoperative CT and intraoperative fluoroscopy guided bronchoscopic implantation of an RFID marker near the target nodule.
• Thoracoscopic surgery utilizing the RFID marker for real-time localization and precise excision with electrocautery and advanced energy devices.
• Detailed procedural steps including port placement, marker localization, and margin assessment to ensure adequate resection without excessive tissue removal.

Main Results:

• The RFID-guided technique facilitates precise localization and excision of deeply located or hilar-adjacent lung nodules.
• This method allows for adequate resection margins while minimizing unnecessary lung parenchyma removal.
• The approach preserves lung function and reduces the risk of adhesions, maintaining options for future surgeries.

Conclusions:

• The RFID-guided thoracoscopic precision excision technique is a promising alternative for managing small pulmonary nodules in complex anatomical locations.
• This minimally invasive approach offers improved precision, better lung function preservation, and enhanced feasibility for reoperations compared to conventional methods.