title: A new safe and stable spiral wire needle for thoracoscopic resection of lung nodules.
abstract: BACKGROUND
  To show the safety and stability of a spiral wire needle (Somatex; Rietzneuendorf, Germany) in the detection and subsequent thoracoscopic resection of subpleural and/or small nodules of the lung.
  
  
  METHODS
  Under local anesthesia and CT control, 13 patients underwent the positioning of a spiral wire needle into the lung, with the spiral located close to or inside the nodule to be resected. Then the patients underwent video-assisted thoracoscopic surgery resection of the nodules with only two thoracoscopic accesses.
  
  
  RESULTS
  All the nodules were identified due to the precise location of the spiral wire needle. The presence of a stable spiral wire inside the parenchyma has allowed us to put under tension the overlying parenchyma, which had previously been excluded from ventilation. The external traction on the needle facilitates the detection of the nodule and simplifies thoracoscopic resection with a stapler. With this new tool, we have always reached an adequate diagnosis and observed no cases of dislodgment of the needle during the traction maneuvers, nor cases of conversion from thoracoscopy to thoracotomy.
  
  
  CONCLUSIONS
  Although our initial experience is limited, the use of this spiral wire needle has been shown to be extremely advantageous in identifying subpleural and/or small nodules of the lung, even sparing the classic third thoracoscopic access for their resection. The presence of a wire needle with a spiral terminal portion (which is placed firmly inside the lung parenchyma) is very useful for the thoracoscopic resection of pulmonary nodules.
authors.affiliation: Unit of Operative Thoracic Endoscopy, Thoracic Surgery Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore, 3, 20162 Milan, Italy. maxtower@libero.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Torre
authors.forename: Giorgio M
authors.initials: GM
authors.lastname: Ferraroli
authors.forename: Angelo
authors.initials: A
authors.lastname: Vanzulli
authors.forename: Stefano
authors.initials: S
authors.lastname: Fieschi
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009339:Needles; D011446:Prospective Studies; D015642:Radiology, Interventional; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D013906:Thoracoscopy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome