Pulmonary Wedge Resection

Pulmonary Wedge Resection is a multi-departmental procedure involving surgery, radiology and pathology. The procedure begins with a CT-guided injection of Tc-99 MAA (Macro Aggregate Albumin), followed by imaging via gamma camera, to insure proper placement of the radiopharmaceutical to the suspect lesion.

In the OR, the patient is positioned for a VATS procedure. The lung is then deflated and the Daniel Lung Probe is inserted for localization of the radio-tagged tissue. Once located, a wedge resection is performed. The probe is then used in vivo to verify clean margins and used ex vivo to verify the location of the target in the resected wedge for pathology.

This can be done either manually or in conjunction with a robotic surgical system, such as the Intuitive-daVinci™ system.

For a full tutorial on this procedure, please see www.med-ed.virginia.edu/courses/rad/rsnanucs

A proposed diagnostic approach to the patient with the sub-centimeter pulmonary nodule: Techniques that facilitate Video-Assisted Thoracic Surgery excision
Thomas M Daniel (Summer, 2005)
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A novel technique for localization and excisional biopsy of small or ill-defined pulmonary lesions
Thomas M Daniel, Talissa A Altas, Patrice K. Rehm, Mark B Williams, David R Jones, Alexander V Stolin, Spencer B Gay (2004)
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Radioisotope marking under CT guidance and localization using a handheld gamma probe for small or indistinct pulmonary lesions
Karuro Sugi, Yoshikazu Kaneda, Katutoshi Hirasawa and Naoki Kunitani (Dec. 2007)
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Daniel Lung Probe (Available in Angled and Straight configuration)

Dynasil’s Daniel Lung Probe, developed in conjunction with thought leaders in the field of visually assisted thoracoscopic surgery (VATS), addresses the challenges of localizing small, difficult to visualize pulmonary lesions in minimally invasive surgical procedures.

The angled probe features a 310mm shaft length, internal collimation, a narrow 10mm tip and a 30 degree bend. This bend, combined with its small tip diameter, provides excellent visualization and external orientation.  The straight configuration allows for use within either 11mm or 12mm bladeless trocars.

Radioisotope localization facilitates rapid, precise identification of targeted nodule, minimizing resected tissue, while providing feedback to the surgeon of clean margins, prior to the pathology report. This radio-guided solution is a safe and effective alternative to blue dye or Kopans needles, which are typically unreliable. Most importantly, this minimally invasive procedure avoids the time, cost and trauma associated with a complete thoracotomy, a frequent product of a “wait-and-see” approach.

Click here for the Daniel Probe brochure

Daniel Lung Probe (Part # SP-2S10-31D)
*Also available in straight configuration (Part # SP-2S10-31)