Thoracoscopic precision excision technique for small non-palpable lesions using radiofrequency identification lung marking system.

This study introduces a thoracoscopic precision excision technique for small, non-palpable lung nodules using a radio frequency identification (RFID) marking system. For peripheral lung nodules, conventional partial resection using an automatic stapler is frequently employed. However, this approach presents challenges for nodules located in deeper regions or near the hilum, as it is often difficult to achieve adequate resection using staplers alone. While segmentectomy offers a viable alternative by providing sufficient margins, it involves extensive dissection around the pulmonary hilum, which can lead to adhesions that complicate future surgeries and restrict surgical options if reoperations are required. The RFID-guided technique proposed in this study enables real-time localization and precise excision of deeply located or hilar-adjacent nodules while minimizing unnecessary parenchymal resection. This method aims to maintain lung function and preserve the feasibility of potential future interventions by limiting hilum manipulation. The procedure incorporates detailed steps, including port placement, RFID marker localization, and precision excision tailored for challenging tumor locations. Preoperative computed tomography (CT) and intraoperative fluoroscopy are utilized to implant the RFID marker via bronchoscopy near the target nodule, allowing for continuous monitoring and controlled resection margins during surgery. Visual aids, such as a port placement figure and a surgical video, support the procedural explanation, demonstrating the use of electrocautery and advanced energy devices to achieve adequate margins without excessive tissue removal. This RFID-guided approach offers a promising alternative for cases where conventional stapler-based techniques are inadequate, particularly for complex anatomical locations. By facilitating precise, minimally invasive resections, this method may represent a significant advancement in thoracoscopic surgery for small pulmonary nodules.