Localization of small pulmonary nodules for thoracoscopic resection: use of a newly developed hookwire system

We developed a stainless steel spring hookwire, 0.28 mm in diameter and 10 mm in length, with a 30-cm-long, 5-0 nylon monofilament suture firmly attached to its funnel-shaped end. A 21-gauge, 10-cm-long cannula was used as an introducer, and a 24-gauge, 10-cm-long blunt-pointed needle as a pusher. The hookwire was successfully placed into the target pulmonary parenchyma under computed tomography guidance in two patients with a small pulmonary nodule. The attached string served as a clear guide at thoracoscopy. Flexibility of the exposed suture through the skin eased wire management after placement. No wire dislodgement occurred.