Three-dimensional imaging navigation during a lung segmentectomy using an iPad

The requirement for anatomical lung segmentectomies has increased in recent years but this surgical procedure is relatively difficult. We herein present the benefits of using three-dimensional (3D) imaging navigation during a lung segmentectomy via the intra-operative use of an iPad. Fourteen patients who had undergone an anatomic segmentectomy for a primary lung cancer or a metastatic lung tumour between 1 October 2010 and 30 April 2011 were included in this study. Contrast-enhanced scanning was performed twice on each patient, and 3D images were constructed using a workstation. These images were then transferred to an iPad and analysed during the operation using DICOM image viewer software. The study group included 3 men (21%) and 11 women (79%) ranging in age from 57 to 83 (mean 69 +/- 7.8 years). The operative procedure involved a resection in one case each of the right S1, the right S2, the right S2 + S6a, the right S3, the right S6, the left S8 and the left S8 + 9. The left S1 + 2 and the left basal segment were resected in two cases. The left upper division was resected in three cases. All segmentectomies were successful and no major post-operative complications developed in any patient during or after their procedures. No positive margins were detected pathologically. A 3D computed tomography navigation using an iPad enhances the ability to perform a safe and secure segmentectomy.