Ultrasonographic identification of peripheral pulmonary nodules through uniportal video-assisted thoracic surgery.

Abstract

An intrinsic limitation of video-assisted thoracic surgery (VATS) resides in the impossibility to palpate the lung to identify embedded nodules. We wanted to investigate the use of intraoperative ultrasonography to detect pulmonary nodules during uniportal VATS. We describe our initial experience with the identification of peripheral pulmonary nodules with an articulating ultrasound probe introduced through a single VATS incision. The instrument was used in 2 patients with solitary pulmonary nodules and previous history of extrathoracic cancer. The lung nodules were identified by the articulating probe and resected on wide tumor-free margins through uniportal VATS. Subsequent lung palpation through minithoracotomy confirmed the absence of additional lesions. Intraoperative ultrasound scanning of the lung with an articulating probe can be successfully used through uniportal VATS to identify peripheral nodules.