{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:29:15Z","timestamp":1790483355391,"version":"4.1.0"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2008,3,19]],"date-time":"2008-03-19T00:00:00Z","timestamp":1205884800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"published-print":{"date-parts":[[2008,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Video-assisted thoracic surgery (VATS) has become routine and widely accepted for the removal of solitary pulmonary nodules of unknown etiology. Thoracosopic techniques continue to evolve with better instruments, robotic applications, and increased patient acceptance and awareness.<\/jats:p>\n            <jats:p>Several techniques have been described to localize peripheral pulmonary nodules, including pre-operative CT-guided tattooing with methylene blue, CT scan guided spiral\/hook wire placement, and transthoracic ultrasound.<\/jats:p>\n            <jats:p>As pulmonary surgeons well know, the lung and visceral pleura may appear featureless on top of a pulmonary nodule.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case description<\/jats:title>\n            <jats:p>This paper presents a rapid, direct and inexpensive approach to peripheral lung lesion resection by marking the lung parenchyma on top of the nodule using direct methylene blue injection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In two patients with peripherally located lung nodules (n = 3) scheduled for VATS, we used direct methylene blue injection for intraoperative localization of the pulmonary nodule. Our technique was the following: After finger palpation of the lung, a spinal 25 gauge needle was inserted through an existing port and 0.1 ml of methylene blue was used to tattoo the pleura perpendicular to the localized nodule.<\/jats:p>\n            <jats:p>The methylene blue tattoo immediately marks the lung surface over the nodule. The surgeon avoids repeated finger palpation, while lining up stapler, graspers and camera, because of the visible tattoo. Our technique eliminates regrasping and repalpating the lung once again to identify a non marked lesion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Three lung nodules were resected in two patients. Once each lesion was palpated it was marked, and the area was resected with security of accurate localization. All lung nodules were resected in totality with normal lung parenchymal margins. Our technique added about one minute to the operative time. The two patients were discharged home on the second postoperative day, with no morbidity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>VATS with intraoperative tattooing is a safe, easy, and accurate technique to streamline and efficiently resect solitary pulmonary nodules.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1749-8090-3-13","type":"journal-article","created":{"date-parts":[[2008,3,19]],"date-time":"2008-03-19T07:13:20Z","timestamp":1205910800000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["VATS intraoperative tattooing to facilitate solitary pulmonary nodule resection"],"prefix":"10.1186","volume":"3","author":[{"given":"Lourens","family":"Willekes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherif","family":"Boutros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Goldfarb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2008,3,19]]},"reference":[{"issue":"5","key":"113_CR1","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.2214\/ajr.165.5.7572485","volume":"165","author":"LR Kaiser","year":"1995","unstructured":"Kaiser LR, Shrager JB: Video-assisted thoracic surgery, the current state of the art. AJR Am J Roentgenol. 1995, 165 (5): 1111-7.","journal-title":"AJR Am J Roentgenol"},{"issue":"6","key":"113_CR2","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1016\/S0003-4975(10)63066-4","volume":"41","author":"P Calhoun","year":"1986","unstructured":"Calhoun P, Feldman PS, Armstrong P, Black WC, Pope TL, Minor GR, Daniel TM: The clinical outcome of needle aspirations of the lung when cancer is not diagnosed. Ann Thorac Surg. 1986, 41 (6): 592-6.","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"113_CR3","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1378\/chest.115.2.563","volume":"115","author":"K Suzuki","year":"1999","unstructured":"Suzuki K, Nagai K, Yoshida J, Ohmatsu H, Takahashi K, Nishimura M, Nishiwaki Y: Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest. 1999, 115 (2): 563-8. 10.1378\/chest.115.2.563.","journal-title":"Chest"},{"issue":"2","key":"113_CR4","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1055\/s-2002-20100","volume":"174","author":"FP Poretti","year":"2002","unstructured":"Poretti FP, Brunner E, Vorwerk D: Simple localization of peripheral pulmonary nodules \u2013 CT-guided percutaneous hook-wire localization. Rofo. 2002, 174 (2): 202-7.","journal-title":"Rofo"},{"issue":"2","key":"113_CR5","doi-asserted-by":"publisher","first-page":"297","DOI":"10.2214\/ajr.163.2.7518642","volume":"163","author":"FX Lenglinger","year":"1994","unstructured":"Lenglinger FX, Schwarz CD, Artmann W: Localization of pulmonary nodules before thoracoscopic surgery: value of percutaneous staining with methylene blue. AJR Am J Roentgenol. 1994, 163 (2): 297-300.","journal-title":"AJR Am J Roentgenol"},{"issue":"1","key":"113_CR6","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/S0003-4975(99)00459-2","volume":"68","author":"R Santambrogio","year":"1999","unstructured":"Santambrogio R, Montorsi M, Bianchi P, Mantovani A, Ghelma F, Mezzetti M: Intraoperative ultrasound during thoracoscopic procedures for solitary pulmonary nodules. Ann Thorac Surg. 1999, 68 (1): 218-22. 10.1016\/S0003-4975(99)00459-2.","journal-title":"Ann Thorac Surg"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-3-13.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1749-8090-3-13\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-3-13","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-3-13.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:28:17Z","timestamp":1630456097000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/1749-8090-3-13"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,3,19]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2008,12]]}},"alternative-id":["113"],"URL":"https:\/\/doi.org\/10.1186\/1749-8090-3-13","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,3,19]]},"assertion":[{"value":"2 September 2007","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2008","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2008","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"13"}}