A SIMPLE WAY TO INDICATE PULMONARY NODULES AT THORACOSCOPIC WEDGE RESECTIONS

Purpose: Small pulmonary subpleural nodules are sometimes difficult to localise at thoracotomy. With the advent of minimal invasive surgery, thoracoscopic resection avoiding anterolateral thoracotomy is an attr active procedure. Since this technique does not allow manual palpation , preoperative indication of lesions is mandatory. A simple and cost-e ffective system for preoperative CT-guided localisation of small subpl eural nodules before thoracoscopic resection is described. Material an d Methods: The system consists of a 0.2-mm steel wire 30-40 cm in leng th and a 0.9-mm biopsy needle. The tip of the wire is bent to a hook, and, guided by CT, it is placed in the vicinity of the lesion. The tec hnique was tested in 8 cases. Results: The procedure was possible to p erform in 7 patients. In all instances the wire remained in place when the lung was collapsed during the thoracoscopic procedure. The staple resected part of the lung also contained the lesion when examined ext racorporeally. Conclusion: This simple and inexpensive system was foun d to be useful for indication of pulmonary lesions at thoracoscopic we dge resections.