Marking method for peripheral non-palpable pulmonary nodules using a mobile computed tomography scanner with a navigatio
- PDF / 814,046 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 97 Downloads / 156 Views
HOW TO DO IT
Marking method for peripheral non‑palpable pulmonary nodules using a mobile computed tomography scanner with a navigation system Ryo Fujikawa1 · Yoshiro Otsuki2 · Hidenori Nakamura3 · Kazuhito Funai4 · Toru Nakamura1 Received: 10 December 2019 / Accepted: 28 February 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Intraoperative localization is essential for video-assisted thoracoscopic surgery of non-palpable pulmonary nodules. Although a computed tomography (CT) guided hook-wire localization is widely used, it might be accompanied by a rare but fatal complication such as an air embolism. We applied a mobile CT scanner with a navigation system to resolve this problem. The three-dimensional images obtained by the mobile CT scanner were transferred to the navigation system, which allowed for virtual fluoroscopy to scan the nearest skin site from the target lesion using a navigation probe. The lung surface was stamped by a dyed gauze ball anchored just beneath the skin marking and a needle was placed at this point as a landmark. With this method, we could verify the positional relationship between the needle and target lesion by the additional CT scan without any procedure-related morbidity. Keywords Ground glass nodule · Mobile computed tomography · Navigation system · Image-guided video-assisted thoracoscopic surgery
Introduction Widespread use of low dose computed tomography (CT) in lung cancer screening has led to the increased detection of small pulmonary nodules such as ground glass nodules. Because those lesions are difficult to detect either by visual inspection or digital palpation, an accurate intraoperative localization technique is essential. Although a CT-guided Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11748-020-01332-3) contains supplementary material, which is available to authorized users. * Ryo Fujikawa [email protected] 1
Department of General Thoracic Surgery, Seirei Hamamatsu General Hospital, Naka‑ku Sumiyoshi 2‑12‑12, Hamamatsu, Shizuoka 430‑8558, Japan
2
Department of Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
3
Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
4
First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
hook-wire localization method for peripheral non-palpable nodules has been widely accepted because of its simplicity and effectiveness [1–3], the hook-wire insertion might cause air embolisms by permitting the passage of air between the bronchiole and adjacent pulmonary vasculature [4]. It rarely occurs [2, 4], but could be fatal [5] and is inevitable as long as a percutaneous pleural puncture is required. We introduced a mobile CT scanner with a navigation system as a substitute for the CT guided hook-wire marking.
Technique A mobile CT scanner (O-arm™, Medtronic Japan Co. Ltd., Tokyo, Japan) and navigation system (Stealth Station™ S7, Medtronic Japan Co. Ltd., Tokyo, Japan) were
Data Loading...
