CT-guided Placement of Microcoils Helps with VATS for Lung Nodules

The Radiological Society of North America is reporting on new technology, developed at the University of British Columbia in Vancouver, that can guide the removal of small nodules within lungs. By preoperatively placing special fiber coated microcoils into the lung under CT guidance, a surgeon performing video-assisted thoracoscopic surgery (VATS) can remove a nodule with little damage to the surrounding tissue.
From the press release:

VATS is a minimally invasive technique in which one or more small incisions are made in the patient’s chest and a small fiber optic camera and surgical instruments are inserted through the incisions. Images transmitted by the camera guide the physician through the procedure.
VATS can replace a traditional thoracotomy, a surgical procedure that uses one larger incision to gain access to the chest. VATS typically results in less pain and faster recovery time for the patient compared to open surgery.
Because small, peripheral lung nodules can be difficult to locate, physicians often have to resort to the more invasive thoracotomy procedure, removing larger amounts of lung tissue to successfully locate small nodules.
For the study, Dr. Mayo and colleagues used CT-guided microcoil placement to assist in VATS removal of 75 small, peripheral lung nodules in 69 patients ranging in age from 31 to 81 years. Four patients had two nodules treated, and two of the patients had second nodules removed at a later date. In all, 75 procedures were performed. The microcoil technique allowed the researchers to locate 100 percent of small nodules, and 97 percent of the lung nodules were successfully and completely removed with VATS.
The results show that with precise microcoil localization, even small nodules can be removed with VATS.
“The real beauty of this procedure is that we are able to remove the entire nodule and very little surrounding tissue, so there is no decrease in lung function,” Dr. Mayo said. “Recovery time is significantly reduced in these patients as a result. Instead of the three- to six-week recovery period that follows a thoracotomy, these patients can return to work within two to three days.”

Press release: Microcoils Help Locate Small Lung Nodules …
Abstract: Lung Nodules: CT-guided Placement of Microcoils to Direct Video-assisted Thoracoscopic Surgical Resection Radiology 2009;250:576-585.
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