Intrathoracoscopic localization techniques

Sortini, Davide; Feo, Carlo V.; Maravegias, Konstantinos; Carcoforo, Paolo; Pozza, E; Liboni, A; Sortini, A

doi:10.1007/s00464-005-0407-z

Cited by 50 publications

(54 citation statements)

References 79 publications

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“…In contrast with conventional lung-marking techniques, which usually involve the placement of visible markings near an invisible or hardly palpable tumor (2), lung mapping provides "geometric information" on the lung's surface by placing multiple dye markings bronchoscopically (1,3) (Figure 1). Because of the very low risk of pneumothorax with this technique (3-4%), and the anatomical liberty available during bronchoscopic marking (3,4), the "map" drawn with VAL-MAP not only helps to identify the tumor, but also helps to determine oncologically appropriate resection lines.…”

Section: Introductionmentioning

confidence: 99%

Techniques of stapler-based navigational thoracoscopic segmentectomy using virtual assisted lung mapping (VAL-MAP)

Sato¹,

Murayama²,

Nakajima³

2016

J. Thorac. Dis.

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Anatomical segmentectomies play an important role in oncological lung resection, particularly for ground-glass types of primary lung cancers. This operation can also be applied to metastatic lung tumors deep in the lung. Virtual assisted lung mapping (VAL-MAP) is a novel technique that allows for bronchoscopic multi-spot dye markings to provide "geometric information" to the lung surface, using three-dimensional virtual images. In addition to wedge resections, VAL-MAP has been found to be useful in thoracoscopic segmentectomies, particularly complex segmentectomies, such as combined subsegmentectomies or extended segmentectomies. There are five steps in VAL-MAP-assisted segmentectomies: (I) "standing" stitches along the resection lines; (II) cleaning hilar anatomy; (III) confirming hilar anatomy; (IV) going 1 cm deeper; (V) step-by-step stapling technique. Depending on the anatomy, segmentectomies can be classified into linear (lingular, S6, S2), V-or U-shaped (right S1, left S3, S2b + S3a), and three dimensional (S7, S8, S9, S10) segmentectomies. Particularly three dimensional segmentectomies are challenging in the complexity of stapling techniques. This review focuses on how VAL-MAP can be utilized in segmentectomy, and how this technique can assist the stapling process in even the most challenging ones.

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Section: Introductionmentioning

confidence: 99%

Techniques of stapler-based navigational thoracoscopic segmentectomy using virtual assisted lung mapping (VAL-MAP)

Sato¹,

Murayama²,

Nakajima³

2016

J. Thorac. Dis.

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“…Controversy regarding its use is based on: (a) the falsenegative rate, which is as high as 29% [17] and approaching 60% among patients with nonspecific benign cytological findings [18]; (b) an incidence of pneumothorax of up to 30%, although only a minority of patients require further treatment [17][18][19][20][21][22] (chest tube in 5%-7% of cases developing pneumothorax); and (c) philosophically, many physicians consider the technique as superfluous and expensive and as an intermediate step with potential morbidity and only a small impact on definitive treatment [23][24][25].…”

Section: Diagnosis Of Indeterminate Pulmonary Nodulesmentioning

confidence: 99%

“…It has been reported that percutaneous biopsy avoids the need for subsequent surgery in only about 10% of patients who are physiologically able to directly undergo surgical resection [23]. In fact, if the lesion is proven to be malignant, surgery is indicated; if the lesion is diagnosed as nonspecific benign, surgical excisional biopsy is also considered.…”

Section: Diagnosis Of Indeterminate Pulmonary Nodulesmentioning

confidence: 99%

Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Solli

Spaggiari

2007

The Oncologist

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After completing this course, the reader will be able to:1. Discuss the role of thoracoscopy in the evaluation of pulmonary nodules and pleural effusion.2. Describe the role of thoracoscopy in the staging of lung cancer.3. Discuss the role of thoracoscopy in surgical resection of early-stage lung cancer.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTThe term video-assisted thoracic surgery (VATS) is used to describe a modern minimally invasive surgical technique that nowadays represents a valid alternative to open procedures (i.e., thoracotomy) for many chest diseases. The VATS approach is presently used in many intrathoracic disorders, but while well established in benign chest disease, its role continues to evolve regarding the management of lung cancer. It is currently considered for the evaluation and treatment of suspected (or known) pleural effusion and in the diagnosis of indeterminate pulmonary nodules, and it has a complementary role to standard cervical mediastinoscopy in the invasive staging of mediastinal lymph nodes. It has also become an accepted approach for resection of peripheral early-stage lung cancer (stage I) in many centers worldwide and considerable experience has been accumulated in respect to this field, but absolute indications have yet to be firmly defined. This paper reviews indications and current data regarding minimally invasive approaches for the staging and treatment of lung cancer.

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“…and avoid the morbidity associated with open thoracotomy [1]. A limitation of VATS is that small nodules or nodules located deeper within the lung parenchyma are difficult to visualize [2].…”

mentioning

confidence: 99%

Lung nodules in children: video-assisted thoracoscopic surgical resection after computed tomography–guided localization using a microcoil

Heran

Sangha

Mayo

et al. 2011

Journal of Pediatric Surgery

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Intrathoracoscopic localization techniques

Abstract: No ideal localization technique is available; thus, the choice still depends on surgeon's preference and local availability of both specialists and instruments.

Cited by 50 publications

References 79 publications

Techniques of stapler-based navigational thoracoscopic segmentectomy using virtual assisted lung mapping (VAL-MAP)

Techniques of stapler-based navigational thoracoscopic segmentectomy using virtual assisted lung mapping (VAL-MAP)

Indications and Developments of Video-Assisted Thoracic Surgery in the Treatment of Lung Cancer

Lung nodules in children: video-assisted thoracoscopic surgical resection after computed tomography–guided localization using a microcoil

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