Remedial localization after dislodgement of primary mechanical localization in lung surgery

Accurate localization of solitary pulmonary nodules (SPNs) has remained a big challenge in lung surgery, especially when the diameter is <15 mm and the nodule is >10 mm under the surface of visceral pleura (1). Computed tomography (CT)-guided percutaneous localization with hookwire or microcoil is one of the most commonly used localization techniques (2). Both hookwire and microcoil have been found to have high success rate and low complication rate in previous studies (3-5). Microcoil placement can also reduce conversion to thoracotomy, operation time, and stapler firings (6). However, unhooking and displacement, among other complications, like pneumothorax, hemorrhage, or dislodgement, do occur (5-8)