Localization of pulmonary nodules prior to videothoracoscopic surgery by CT-guided hook wire placement

PURPOSE: To localize peripheral lung nodules under CT guidance using hookwires, prior to video-assisted thoracic surgery (VATS). PATIENTS AND METHODS: Twenty-two pulmonary nodules were localized with a hookwire under CT guidance. The visceral pleura was stained with methylene blue. VATS was performed thereafter. RESULTS: All nodules were successfully localized and resected without significant complications. CONCLUSIONS: In select cases, localization of pulmonary nodules with hook wire and methylene blue allows the thoracoscopic resection of unaccessible lesions.