Minimally Invasive Surgery is Changing the Early Detection of Lung Cancer

Minimally invasive surgery is changing the early detection of lung cancer by innovating ways of tracking lung nodules when lung cancer is suspected.How is minimally invasive surgery changing the early detection of lung cancer?

The majority of lung cancer surgeries are now performed using minimally invasive approaches. Above 80 percent at Emory. This presents advantages to the patient: less muscle is cut and recovery is quicker. Traditionally surgeons would need to touch the nodule to find it, and accessing the lung via smaller incisions prevents that hands on touch.

When it comes to lung cancer early detection, we have to remember that the lung tissue is normally filled with air, sort of like a puffy sleeping bag. When someone gets a CT scan and a nodule is detected, the air is present. During surgery, the tissue collapses, causing the nodule to shift away from where it was.

At Winship, cardiothoracic surgeons Manu Sancheti, Seth Force and colleagues have been developing a technique of using gold markers. It’s called fiducials and it keeps track of small nodules when lung cancer is suspected. The minimally invasive surgeons published their findings in 2014 in the Annals of Thoracic Surgery.

During a CT scan the radiologist will mark a nodule by inserting a fiducial, which is then visible during the operation via fluoroscopy. This allows the surgeon to precisely cut out the appropriate lung tissue containing the nodule.

“Some nodules are small enough that it’s difficult to feel them at all,” Force says. “Rather than take as many as 45 minutes to hunt around for a nodule during surgery, gold markers are an attractive and accurate alternative.”

Sometimes, cancer can be diagnosed and removed in one day. Some nodules are located deeper, so that it’s harder to access them by needle biopsy first.

A sample from a nodule can be removed during minimally invasive surgery, sent to the pathology lab, and within 30 minutes, the surgeon can have an answer to the question: is it cancer?

Lung cancer remains the number one cancer killer in the U.S. It takes the lives of more people than breast, prostate and colon cancers combined. Lung screenings help lung cancer patients with early diagnosis and increased survival rates through options such as gold markers and minimally invasive surgery. Emory Healthcare’s low-radiation-dose lung screening is available for patients with a significant smoking history. Visit emoryhealthcare.org/lungct to learn more about screening qualifications.

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