Thoracoscopic lung resection for extremely small nodular lesions using simultaneous intraoperative real-time computed tomography.

Because the localization of small lung nodules at thoracoscopic resection is sometimes difficult, we have employed intraoperative real-time computed tomography (CT). Two patients with lung nodules less than 1 cm in diameter were treated using this technique. Detection of the lesion using CT and thoracoscopic resection is performed simultaneously in the interventional radiological CT examination room. After induction of general anesthesia with one-lung ventilation, the patient is placed in the lateral position. The lung nodule is detected using real-time CT and grasped with forceps. Thoracoscopic resection of the nodule is performed in the usual fashion. Frozen section examination is immediately performed to decide on further therapy.