title: Video-assisted thoracoscopic surgery using mobile computed tomography: new method for locating of small lung nodules.
abstract: BACKGROUND
  The O-arm is an intraoperative imaging device that can provide computed tomography images. Surgery for small lung tumors was performed based on intraoperative computed tomography images obtained using the O-arm. This study evaluated the usefulness of the O-arm in thoracic surgery.
  
  
  METHODS
  From July 2013 to November 2013, 10 patients with small lung nodules or ground glass nodules underwent video-assisted thoracoscopic surgery using the O-arm. A needle was placed on the visceral pleura near the nodules. After the lung was re-expanded, intraoperative computed tomography was performed using the O-arm. Then, the positional relationship between the needle marking and the tumor was recognized based on the intraoperative computed tomography images, and lung resection was performed.
  
  
  RESULTS
  In 9 patients, the tumor could be seen on intraoperative computed tomography images using the O-arm. In 1 patient with a ground glass nodule, the lesion could not be seen, but its location could be inferred by comparison between preoperative and intraoperative computed tomography images. In only 1 patient with a ground glass nodule, a pathological complete resection was not performed. There were no complications related to the use of the O-arm.
  
  
  CONCLUSIONS
  The O-arm may be an additional tool to facilitate intraoperative localization and surgical resection of non-palpable lung lesions.
authors.affiliation: Department of Thoracic Surgery, Steel Memorial Muroran Hospital, Chiribetsu-cho, 050-0076 Muroran, Hokkaido, Japan. kit_katton0803@yahoo.co.jp.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Ohtaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Kichizo
authors.initials: K
authors.lastname: Kaga
authors.forename: Naoto
authors.initials: N
authors.lastname: Senmaru
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kotani
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Matsui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011013:Pneumonectomy / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*