The hook-wire technique for localization of pulmonary nodules during thoracoscopic resection.

The main problem related to the thoracoscopic resection of lung nodules is the difficulty in locating the target nodule. Among the several methods proposed, one of the most efficient is the preoperative placement of a localization wire into the nodule while it is under computed tomography scan control. After our initial series of 22 thoracoscopic resections of lung nodules without preoperative localization, we have used the hook-wire technique in 21 patients. In our initial series, we had four failures while we have had only one in the hook-wire series. Only two minor complications related to the wire localization technique occurred: a poorly tolerated pneumothorax and an intrapulmonary hemorrhage. There was no postoperative complication. The mean duration of postoperative stay was 1 to 6 days. We conclude that the preoperative localization of lung nodules using a hook wire is a safe and accurate method before thoracoscopic resection in selected patients.