Make visible palpable, a “double-insurance strategy” for nodule localization

Localization for tiny pulmonary nodule during video-assisted thoracoscopic surgery (VATS) approach to facilitate sublobar resection remains a challenge for thoracic surgeons. To look for a needle in a haystack, adjuvant techniques such as hookwire insertion, colour dye or radionuclide injection have been well reported (1). However, such traditional techniques require a patient being transferred from the radiographic suite for localization and the operation room for resection, which would lead to more substantial complications, for example, pleuritic pain, label or marking migration, and pneumothorax to mention just a few.