Abstract
BackgroundThe O-arm is an intraoperative imaging device that can provide computed tomography images. Surgery for small lung tumors was performed based on intraoperative computed tomography images obtained using the O-arm. This study evaluated the usefulness of the O-arm in thoracic surgery.MethodsFrom July 2013 to November 2013, 10 patients with small lung nodules or ground glass nodules underwent video-assisted thoracoscopic surgery using the O-arm. A needle was placed on the visceral pleura near the nodules. After the lung was re-expanded, intraoperative computed tomography was performed using the O-arm. Then, the positional relationship between the needle marking and the tumor was recognized based on the intraoperative computed tomography images, and lung resection was performed.ResultsIn 9 patients, the tumor could be seen on intraoperative computed tomography images using the O-arm. In 1 patient with a ground glass nodule, the lesion could not be seen, but its location could be inferred by comparison between preoperative and intraoperative computed tomography images. In only 1 patient with a ground glass nodule, a pathological complete resection was not performed. There were no complications related to the use of the O-arm.ConclusionsThe O-arm may be an additional tool to facilitate intraoperative localization and surgical resection of non-palpable lung lesions.
Highlights
The O-arm is an intraoperative imaging device that can provide computed tomography images
To perform surgery for small lung tumors that include ground glass nodules (GGNs), preoperative or intraoperative procedures to identify the locations of the tumors are generally needed
Surgery for small lung tumors that included GGNs was performed based on intraoperative computed tomography (CT) images using the O-arm
Summary
The O-arm is an intraoperative imaging device that can provide computed tomography images. Surgery for small lung tumors was performed based on intraoperative computed tomography images obtained using the O-arm. The O-arm Surgical Imaging System (Medtronic Japan Co., Ltd., Tokyo, Japan) is an intraoperative, full-rotation, multidimensional image system that functions as an intraoperative imaging device with a flat-panel detector that provides two-dimensional (2D) fluoroscopic imaging and three-dimensional (3D) cone-beam CT imaging (Figure 1). This system has been used in spine, orthopedic, and trauma-related surgeries, and has recently been used in neurosurgery [11,12,13]. We hypothesized that the O-arm could be used for small lung tumors
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