New approach method based on intraoperative CT images using the O-arm Surgical Imaging System in thoracoscopic surgery for a ground glass nodule

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  • すりガラス状結節に対する胸腔鏡下肺切除術における術中可動型CT（O-arm）の使用経験―触知不能肺腫瘍に対する新たなアプローチ法―

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Abstract

The O-arm Surgical Imaging System is an intraoperative imaging device that performs two-dimensional fluoroscopic imaging and three-dimensional computed tomography (CT). There have been no reports on O-arm use in thoracic surgery. We performed the surgery for a patient with a ground glass nodule (GGN) based on intraoperative CT images using O-arm. With the intrathoracic stamping method, a needle with thread was placed on the visceral pleura near the tumor. After the lung was re-expanded, intraoperative CT using O-arm was performed. The positional relationship between the needle mark and tumor was recognized based on the intraoperative CT images, and lung resection was performed. In the patient with a GGN of 10 mm in diameter in the left upper lobe, the lesion was clearly shown on intraoperative CT images using O-arm, and we performed pathologically complete resection. O-arm may make it possible to perform surgery for a non-palpable lung tumor, and it may become a new procedure in thoracic surgery.

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