Three-dimensional simulation-based wedge resection for non-palpable small lung lesions

Area of Science:

• Thoracic Surgery
• Surgical Simulation
• Oncology

Background:

• Three-dimensional (3D) simulation is established for anatomical segmentectomy but less standardized for wedge resection.
• Intraoperative localization and margin control can be challenging for non-palpable small lung lesions during wedge resection.

Purpose of the Study:

• To describe a novel 3D simulation-based technique for precise wedge resection of selected non-palpable small lung lesions.
• To enhance localization and margin control in parenchyma-sparing lung resections.

Main Methods:

• Preoperative 3D simulation to identify critical bronchovascular structures and define a constrained transection surface with adequate margins.
• Intraoperative use of identified structures as landmarks during thoracoscopic surgery.
• Application of staplers along the pre-planned surface for resection.

Main Results:

• The technique allows for precise planning of the transection surface, respecting vital structures.
• It facilitates accurate localization and margin control, particularly for deep or small lesions.
• Enables oncologically acceptable wedge resection with improved reliability over empirical methods.

Conclusions:

• 3D simulation-based wedge resection is a valuable adjunct for planning challenging lung resections.
• This technique improves localization and margin control for parenchyma-sparing procedures.
• It offers a standardized approach for selected cases where empirical wedge resection may be unreliable.