Thoracoscopic anatomic pulmonary segmentectomy: a 3-dimensional guided imaging system for lung operations

Objectives To evaluate the Lung Operation Three-dimensional Imaging System software by Xiamen TRONG Technology Co. Ltd in detecting the precise position of solitary pulmonary nodules or ground-glass opacity nodules before surgery. Methods Chest, arterial phase, portal venous phase, enhanced and delayed-phase images of 10 cases with 12 nodules were obtained with a Toshiba Aquilion One 320 computed tomography (CT) scanner. According to the image data of the nodules, 0.5 mm thick images of 320-row multislice CT scanners were reconstructed as 3D images, and the boundary of each segment was automatically partitioned and pigmented in accordance with the pulmonary artery system. To locate the nodules, the 3D images and coloured segments were merged. The clearly labelled lung structure was utilized in a preoperative virtual segmentectomy and the subsequently planned thoracoscopic surgery. Results In all 10 cases, the reconstruction of the pulmonary artery could image branches as far as Grade 5. The anatomically adjacent relationship of the nodules among the arteries, veins and bronchi in the target pulmonary segments could be displayed in any view. The thoracoscopic anatomic pulmonary segmentectomy was performed successfully. All 12 nodules, which had deeply settled in the parenchyma, were resected using the virtual planning software and diagnosed pathologically. Conclusions The software can be used preoperatively as a tracing method to identify the location of nodules in most general thoracic surgeries, subsequently providing guidance during the surgery.