• Takashi Anayama, Kentaro Hirohashi, Hironobu Okada, Ryohei Miyazaki, Nobutaka Kawamoto, Marino Yamamoto, and Kazumasa Orihashi.
• Department of Surgery II, Kochi Medical School, Kochi University, Nankoku, Japan.
• Thorac Cancer. 2019 Mar 1; 10 (3): 579-582.

AbstractThe increasing need for pulmonary resection by video-assisted thoracoscopic surgery (VATS) has presented a greater opportunity to detect small-sized pulmonary nodules by computed tomography (CT). In cases where it is difficult to identify tumor localization intraoperatively, it is necessary to place the VATS marker near the pulmonary nodules before surgery. Conventional percutaneous or bronchoscopic VATS marker placement under local anesthesia is accompanied by patient pain. We clinically applied a new technique to place VATS markers using a bronchoscope under general anesthesia in a hybrid operating room. Multiple pulmonary nodules were successfully marked and securely excised simultaneously by VATS. This technique enables secure, minimally invasive resection of multiple small-sized pulmonary nodules without causing distress to the patient.© 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

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