Planning video-assisted thoracic surgery segmentectomy using three dimensional computed tomography angiography and bronchography with a virtual safety margin

Shingo Iwano


In segmentectomy using video-assisted thoracic surgery (VATS), surgeons view the operative field on a 2-dimensional video monitor. The lack of ability to palpate organs directly frequently leads to difficulties in evaluating anatomic relations. Three-dimensional computed tomography angiography and bronchography (3D-CTAB) using a virtual 3D safety margin enables thoracic surgeons to recognize the distance and positional relation between the primary tumor and intersegmental veins. It also helps with surgical planning, allowing the surgeon to secure an adequate safety margin around the primary tumor. We report two patients with double primary lung cancer who underwent segmentectomy based on preoperative simulation 3D-CTAB with a virtual 3D safety margin.