Skip to main content
Top
Published in:

26-07-2023 | Thoracotomy | Original Article

Trans-fissure and trans-lobar coil insertion technique for small lesions positioned inside the fissure

Authors: Rushmi Purmessur, James Waugh, Michael Crawford, Vasileios Kouritas

Published in: Updates in Surgery | Issue 8/2023

Login to get access

Abstract

The objective of this study is to present a technique of localization of difficult-to-locate lesions inside the fissure by deploying a coil with one of its ends left inside the fissure, and also, to evaluate the safety and the efficiency of this localization technique. Ten (10) patients with lesions in the fissure were identified during discussion at the multidisciplinary team meeting (MDT) and were recruited in the study. Attending surgeons verified that the lesions were unable to be located with minimally invasive approaches. These patients underwent localization of their lesion/s inside the fissure with a coil which was inserted through an adjacent lobe, through the fissure and inside the lesion with the other end protruding inside the fissure. All patients were next subjected to resection of their lesions with minimally invasive approaches. All patients had their lesions resected (with wedge resection or segmentectomies) with adequate margins (R0 resection). No conversion to thoracotomy was necessitated to attempt to palpate the lesion. Small, localized pneumothorax was noted in 7 patients; whereas, all patients had small laceration of their lung parenchyma along the course of the needle without, however, any action needed for these sequalae. The presented technique offers precise localization which leads to successful and safe resection of difficult-to-locate lesions inside the fissure via minimally invasive approaches. The clinical implications of this technique are numerous and its utilization can augment the successful performance of minimally invasive techniques for lesions situated inside the fissure.
Literature
1.
go back to reference Donahoe LL, Nguyen E, Chung TB, Kha LC, Cypel M, Darling GE et al (2016) CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature. J Thorac Dis 8:1986–1994CrossRefPubMedPubMedCentral Donahoe LL, Nguyen E, Chung TB, Kha LC, Cypel M, Darling GE et al (2016) CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature. J Thorac Dis 8:1986–1994CrossRefPubMedPubMedCentral
2.
3.
go back to reference Mayo JR, Clifton JC, Powell TI, English JC, Evans KG, Yee J et al (2009) Lung nodules: CT-guided placement of microcoils to direct video-assisted thoracoscopic surgical resection. Radiology 250:576–585CrossRefPubMed Mayo JR, Clifton JC, Powell TI, English JC, Evans KG, Yee J et al (2009) Lung nodules: CT-guided placement of microcoils to direct video-assisted thoracoscopic surgical resection. Radiology 250:576–585CrossRefPubMed
4.
go back to reference Bommart S, Bourdin A, Marin G, Berthet JP, Pujol JL, Serre I et al (2014) Impact of preoperative marking coils on surgical and pathologic management of impalpable lung nodules. Ann Thorac Surg 97:414–418CrossRefPubMed Bommart S, Bourdin A, Marin G, Berthet JP, Pujol JL, Serre I et al (2014) Impact of preoperative marking coils on surgical and pathologic management of impalpable lung nodules. Ann Thorac Surg 97:414–418CrossRefPubMed
5.
go back to reference Fu Y, Gao Y, Zhang M, Wang T, Shi YB, Huang YY (2019) Computed tomography-guided simultaneous coil localization as a bridge to one-stage surgery for multiple lung nodules: a retrospective study. J Cardiothorac Surg 14:43CrossRefPubMedPubMedCentral Fu Y, Gao Y, Zhang M, Wang T, Shi YB, Huang YY (2019) Computed tomography-guided simultaneous coil localization as a bridge to one-stage surgery for multiple lung nodules: a retrospective study. J Cardiothorac Surg 14:43CrossRefPubMedPubMedCentral
7.
go back to reference Suzuki K, Saji H, Aokage K, Watanabe S, Okada M, Mizusawa J et al (2019) Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. JCVTS 158:895–907 Suzuki K, Saji H, Aokage K, Watanabe S, Okada M, Mizusawa J et al (2019) Comparison of pulmonary segmentectomy and lobectomy: Safety results of a randomized trial. JCVTS 158:895–907
8.
go back to reference Flores RM, Park BJ, Dycoco J, Aronova A, Hirth Y, Rizk NP et al (2009) Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer. JTCVS 138:11–18 Flores RM, Park BJ, Dycoco J, Aronova A, Hirth Y, Rizk NP et al (2009) Lobectomy by video-assisted thoracic surgery (VATS) versus thoracotomy for lung cancer. JTCVS 138:11–18
9.
go back to reference Sihoe ADL (2020) Video-assisted thoracoscopic surgery as the gold standard for lung cancer surgery. Respirology 25:49–60CrossRefPubMed Sihoe ADL (2020) Video-assisted thoracoscopic surgery as the gold standard for lung cancer surgery. Respirology 25:49–60CrossRefPubMed
10.
go back to reference Ma J, Li X, Zhao S, Wang J, Zhang W, Sun G (2021) Robot-assisted thoracic surgery versus video-assisted thoracic surgery for lung lobectomy or segmentectomy in patients with non-small cell lung cancer: a meta-analysis. BMC Cancer 21:498CrossRefPubMedPubMedCentral Ma J, Li X, Zhao S, Wang J, Zhang W, Sun G (2021) Robot-assisted thoracic surgery versus video-assisted thoracic surgery for lung lobectomy or segmentectomy in patients with non-small cell lung cancer: a meta-analysis. BMC Cancer 21:498CrossRefPubMedPubMedCentral
Metadata
Title
Trans-fissure and trans-lobar coil insertion technique for small lesions positioned inside the fissure
Authors
Rushmi Purmessur
James Waugh
Michael Crawford
Vasileios Kouritas
Publication date
26-07-2023
Publisher
Springer International Publishing
Published in
Updates in Surgery / Issue 8/2023
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-023-01590-9

Other articles of this Issue 8/2023

Updates in Surgery 8/2023 Go to the issue
Webinar | 06-02-2024 | 20:00 (CET)

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by: Viatris

Developed by: Springer Healthcare