Image-Guided Localization for Video-Assisted Thoracic Surgery

Spirn, Paul W.; Shah, Rosita M.; Steiner, Robert M.; Greenfield, Antje L.; Salazar, Ana Marı́a; Liu, Ji‐Bin

doi:10.1097/00005382-199710000-00006

Cited by 13 publications

(9 citation statements)

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“…Other indications are the resection The principal reason for failure in thoracoscopic surgery is that in some patients it is impossible to localize target lesions. In fact, when the nodule is not visible as a swelling on the overlying pleural surface, the surgeon tries to localize it with a finger or by utilizing thoracoscopic tools; yet, if he/she still cannot localize it, he/she must convert thoracoscopy into thoracotomy in order to perform manual palpation [7,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…As an alternative to hook-wire placement, CT-guided percutaneous staining with methylene blue can be used. Intraoperative sonography is one of the last localization techniques to be introduced, but it soon showed several intraoperative advantages such as its repeatability, the lack of complications and/or morbidity related to the method, its ability to define margins, dimensions and structural characteristics of the lesions and their own adjacent structures and its low cost [4,5,7,10]. Furthermore, it does not cause exposure to ionizing radiation, it can be used for multiple and bilateral lesions and it is able to localize lesions less than 10 mm in diameter which might not be visualized at preoperative exams.…”

Section: Discussionmentioning

confidence: 99%

“…Lung collapse is mandatory to perform ultrasonography and anaesthesia assistance is crucial in order to extract the greatest amount of air from the parenchyma through selective contralateral ventilation and homolateral bronchial aspiration [3,7].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonographic localization of occult pulmonary nodules during video-assisted thoracic surgery

et al. 2003

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The aim of our study was to evaluate the role of ultrasonography in the localization of pulmonary nodules during video-assisted thoracic surgery (VATS). Ultrasonography was performed in 35 patients for the localization of pulmonary nodules during VATS. Indication for VATS was excisional biopsy of undetermined nodules in 22 patients, single or multiple metastasectomy in 12 patients and resection of primitive pulmonary cancer in 1 patient with reduced pulmonary reserve. A laparoscopic probe with flexible head and multi-frequency transducer (5-7.5 MHz) was used. Intraoperative ultrasonography localized 37 of 40 nodules preoperatively detected by CT and/or by positron emission tomography in 35 patients. Furthermore, ultrasonography localized two nodules not visualized at spiral CT. Eighteen nodules were not visible or palpable at thoracoscopic examination and were found by intraoperative sonography only. In 6 patients in whom thoracotomy was performed, manual palpation did not reveal more lesions than ultrasonography. In our experience, ultrasonography was very helpful when lesions were not visible or palpable during thoracoscopy, showing high sensitivity (92.5%) in finding pulmonary nodules. Since it is not possible to determine preoperatively whether a localization technique will be necessary during the operation or not, and ultrasonography is a non-invasive technique, we think that, at present, this technique can be considered as the first-instance localization technique during thoracoscopic resection of pulmonary nodules.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ultrasonographic localization of occult pulmonary nodules during video-assisted thoracic surgery

et al. 2003

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“…Preoperative image-guided localization associated with VATS has been reported as a useful therapeutic tool in the management of thoracic disease [9,10,36]. Although combining these techniques is not a new concept, its use in spine surgery has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Curetting Osteoid Osteoma of the Spine Using Combined Video-assisted Thoracoscopic Surgery and Navigation

Campos

Gasbarrini

Boriani

2013

Clinical Orthopaedics &Amp; Related Research

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Background A spinal osteoid osteoma is a rare benign tumor. The usual treatment involves complete curettage including the nidus. In the thoracic spine, conventional open surgical treatment usually carries relatively high surgical risks because of the close anatomic relationship to the spinal cord, nerve roots, and thoracic vessels, and pulmonary complications and postoperative pain. Case Report We report the case of a 16-year-old girl with a symptomatic osteoid osteoma at the T9 level whose lesion was currettaged using video-assisted thoracoscopic surgery (VATS) guided by a navigation system (VATS-NAV). There were no complications and the patient had immediate relief of the characteristic pain after surgery and was asymptomatic at 5 months' followup. Literature Review Progressive advances in the technology of spinal surgery have evolved to offer greater safety and less morbidity for patients. The advent of minimally invasive surgery has expanded the indications for VATS for anterior spinal disorders. Spinal navigation systems have become useful tools allowing localization and excision of the nidus of osteoid osteomas with minimal bone resection and without radiation exposure. Clinical Relevance The VATS-NAV combination in our patient allowed accurate localization and guidance for complete excision of a spinal osteoid osteoma through a minimally invasive approach without compromising spinal stability.

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“…Furthermore, the patients treated in this manner were able to avoid a more extensive thoracotomy incision. Pilot studies of both immediate preoperative and intraoperative real-time CT scanning for localization of sub-centimeter lung nodules have shown some promise to this end as well [24,32]. Further studies are needed to help elucidate this potential modality for resection of small nodules that are difficult to localize.…”

Section: Technical Implicationsmentioning

confidence: 99%