Fluorescent-guided Thoracoscopic Lung Segmentectomy for Ground Glass Lesion: Intraoperative Localization with Electromagnetic Navigational Bronchoscopy

Kook Nam Han, Hyun Koo Kim, Kanghoon Lee, Young Ho Choi

Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea

Purpose : VATS resection of small pulmonary nodule or nonpalpable ground glass lesion is challenging. In this video, we performed image-guided single port VATS wedge resection following segmentectomy for indeterminate ground glass lesion with intraoperative dye localization by electromagnetic navigational bronchoscopy (ENB).

Methods : We planned a VATS wedge resection for 1-cm sized ground glass lesion in 73-year old male under ENB-guided localization with fluorescence. Potential diagnosis was non-small cell lung cancer.

Results : Under general anesthesia with single lumen intubation, we performed ENB guided localization with fluorescent dye. After position change to right lateral decubitus, image-guided wedge resection was performed under single port VATS approach. The frozen biopsy was adenocarcinoma, so we converted to segmentectomy. We performed intravenous ICG injection to identify the intersegmental plane during segmentectomy.

Conclusion : This video shows the potential role of fluorescence localization by ENB for image-guided surgry without transthoracic percutaneous interventin.

책임저자: Hyun Koo Kim

Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea

발표자: Kook Nam Han, E-mail : hdoc@korea.ac.kr