Electromagnetic navigational bronchoscopy-guided dye marking to identify the subsegmental bronchus in thoracoscopic anatomic subsegmentectomy

Usefulness of near-infrared fluorescence for identifying the segmental bronchus in minimally invasive segmentectomy

Minimally invasive anatomical sublobar resections have gained relevance in recent years mainly due to advances in imaging techniques, screening programs and the increase in second neoplasms. Accurate identification of the segmental or subsegmental bronchus is vital to guarantee optimal results in segmentectomies and subsegmentectomies. Given the complexity and the possibility of anatomical variations, several authors have published different methods to identify the target bronchus. However, these methods have certain limitations. This article describes a new rapid and effective technique, with a low risk of complications and without additional cost, for the identification of segmental bronchi in minimally invasive segmentectomies.

Electromagnetic navigational bronchoscopy-guided dye marking to identify the subsegmental bronchus in thoracoscopic anatomic subsegmentectomy

Video‐assisted thoracoscopic surgery (VATS) subsegmentectomy has been widely used to resect small‐sized lung lesions in clinical practice. Precise identification of the subsegmental bronchus is one of the essential steps in performing thoracoscopic anatomic subsegmentectomy. Here, we report a thoracoscopic right S²a segmentectomy with preoperative electromagnetic navigational bronchoscopy (ENB)‐guided injection of methylene blue to identify the subsegmental bronchus in a 51‐year‐old male. We successfully performed complicated surgery using this method. This ENB‐guided dye marking method may accurately distinguish the subsegmental bronchus to effectively guide surgery.