COMPUTED TOMOGRAPHY-GUIDED COIL INJECTION AND THORACOSCOPIC PULMONARYRESECTION UNDER ROENTGENOGRAPHIC FLUOROSCOPY

To remove a small, chest roentgenogram-negative, computed tomogram-pos itive nodule, we developed a novel technique of thoracoscopic pulmonar y resection. This technique consists of the computed tomography-guided coil injection of a metallic coil and subsequent thoracoscopic resect ion under roentgenographic fluoroscopy. During the thoracoscopic resec tion, the fluoroscopic image was a valuable aid in determining the loc ation of the nodule and in ensuring that the stapler was applied with a sufficient distance from the coil. Because this technique helps to d etermine the exact location of the nodule regardless of its depth from the pleural surface, even a minithoracotomy for direct palpation can be avoided.