ENDOFINGER FOR TACTILE LOCALIZATION OF PULMONARY NODULES DURING THORACOSCOPIC RESECTION

To localize a deeply situated small pulmonary nodule during thoracosco pic resection, we developed as instrument a so-called ''endofinger'' f or tactile localization of the nodule, and examined its usefulness. An attempt was made in 26 patients, using endofinger palpation under tho racoscopy, to localize twenty-six pulmonary nodules, each of which was less than 20 mm in diameter (mean 12.2 mm) and situated apart from th e pleural surface. An endofinger comprises an extended 'finger' sectio n connected with a sleeve section. The sleeve section fits with a larg e contract area over the surgeon's forefinger, effectively lengthening it. The surgeon uses an endofinger in each hand and palpates a pulmon ary nodule with the endofinger from two directions simultaneously. Sur geons could feel the hardness of nodules with a high degree of sensiti vity. The sense of touch of the endofinger is much better than that of a simple bar, due to the large contact area of the sleeve section wit h the real finger. With the endofinger palpation 22 of 26 nodules were localized and their margins confirmed. All of 19 nodules larger than 10 mm in size had their locality confirmed by endofinger palpation. Fo ur of 7 nodules smaller than 10 mm in size could not be localized, how ever. The endofinger is a useful instrument for tactile localization o f pulmonary nodules under thoracoscopic surgery, especially for nodule s larger than 10 mm. The method is simple, low-cost, time-saving, and has no complications.