case_images: PMC11786342_01
case_images: A chest CT revealed a GGO (yellow arrow) in the anterior segment of the right upper lobe (Subfigure A). The size of the GGO was approximately 11*9 mm in the lung window, and no visible solid component was observed in the mediastinal window (Subfigure B)
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case_images: PMC11786342_01_13019_2024_3130_Fig1_HTML.jpg
case_images: Fig1
case_images: The largest ground glass opacity (GGO) was located in the anterior segment of the right upper lobe, and the size was approximately 11*9 mm (Fig. 1).
case_images: The mesh nebulizer system (red box) was connected between the double-lumen tube and the heat moisture filter of the ventilator (Subfigure A). The ventilator was employed in volume-controlled mode, providing a tidal volume of approximately 450-500 ml at 12 respirations per minute, setting the inspiratory-to-expiratory ratio to approximately 1:2 (Subfigure B)
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case_images: PMC11786342_01_13019_2024_3130_Fig2_HTML.jpg
case_images: Fig2
case_images: Ltd., Beijing, China) was connected between the double-lumen tube and the heat moisture filter of the ventilator (Fig. 2A). The ventilator was employed in volume-controlled mode, providing a tidal volume of approximately 450-500 ml at 12 respirations per minute, setting the inspiratory-to-expiratory ratio to approximately 1:2 (Fig. 2B).
case_images: Under the overlay imaging window of the near-infrared fluorescence imaging system, the bronchi were shown in green, which contrasts with the surrounding lung tissue (Subfigures A and B). More importantly, the bifurcation of the anterior and apical bronchi could be clearly identified (Subfigures B and C). After the bronchus was fully dissected (Subfigure D), it was cut off with an endoscopic blue stapler (Subfigure E and F)
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case_images: PMC11786342_01_13019_2024_3130_Fig3_HTML.jpg
case_images: Fig3
case_images: During surgery, fluorescence imaging of the lung tissue was not obvious (Fig. 3). Under the overlay imaging window of the NIF imaging system (DPM, Zhuhai Dipu Medical Technology Co., Ltd., Zhuhai, China), the bronchus was shown in green, indicating that the bronchi contrasted with the surrounding lung tissue (Fig. 3A and B). We dissected the bronchi with the assistance of fluorescence imaging and were surprised to find that the bifurcation of the anterior and apical bronchi could be clearly identified by navigation via the inhaled ICG and NIF system (Fig. 3B, C and D). After the bronchus was fully dissected, it was cut off with an endoscopic blue stapler (EndoGIA) (Fig. 3E and F).