The Application Of Semi-rigid Single Hook Wire For Localizing Pulmonary Solitary Nodules During VATS

Purpose:The aim of this study was to compare the effects of currently available preoperative localization methods,including semi-rigid single hook-wire,double-thorn hook-wire,and micro-coil,in localizing the pulmonary nodules,thus to select the best technology to assist video-assisted thoracoscopic surgery(VATS)for small ground glass opacities(GGO).Methods:Preoperative CT-guided localizing techniques including semi-rigid single hook-wire,double-thorn hook-wire and micro-coil were used in re-aerated fresh pig lung for location experiments.The advantages and drawbacks of the three positioning technologies were compared,and then the most optimal technique was used in patients with GGO.Technical success and post-operative complications were used as primary endpoints.Results:All three localizing techniques were successfully performed in the re-aerated fresh pig lung.The median tractive force of semi-rigid single hook wire,double-thorn hook wire and micro-coil were 6.8 N,5.1 N and 0.2 N,which measured by a spring dynamometer.The wound sizes in the superficial pleura,caused by unplugging the needles,were 2 millimeters in double-thorn hook wire,1 millimeter in semi-rigid single hook and 1 millimeter in micro-coil,respectively.In patients with GGOs,the semi-rigid hook wires localization were successfully performed,without any complication that need to be intervened.Dislodgement was reported in one patient before VATS.No major complications related to the preoperative hook wire localization and VATS were observed.Conclusions:We found from our localization experiments in the pig lung that,among the commonly used three localization methods,semi-rigid hook wire showed the best operability and practicability than double-thorn hook wire and micro-coil.Preoperative localization of small pulmonary nodules with single semi-rigid hook wire system shows a high success rate,acceptable utility and especially low dislodgement in VATS.