Preoperative diagnosis: Multiple lung nodules Postoperative diagnosis: Small cell carcinoma of the upper lobe of right lung Procedure performed: Thoracoscopic segmental excision of lung nodules of 53-year-old Indications: A 53-Year-old female presents to the hospital for the excision of multiple lung nodules of the upper lobe of the right lung identified by previous outpatient radiological examination. patient has smoked for 35 years and is a current two-pack-per-day smoker. She also as a family history of lung cancer. Procedure description: Two small incisions were made in the chest wall and carried down into the chest cavity by blunt dissection. A trocar was inserted through a small intercostal incision in the right side of the chest wall. An endoscope was passed through the trocar and into the chest cavity. The right lung was partially collapsed by instilling air into the chest through a second trocar placed via a separate incision. The contents of the chest cavity were examined under direct visualization. Via an endoscope, images were obtained of the lesions, and the instruments were manipulated through the secondary sites, clamping blood vessels and bronchial tubes at the segments of the lung containing the nodules. With the clamps in place, the nodules were removed by dividing the vessel and bronchial tubes isolated by the clamps. The remaining lung tissue was repaired by suture and surgical clips. At the conclusion of the procedure, the endoscope and the trocar(s) were removed. A chest tube was inserted for drainage and re-expansion of the chest cavity. Surgical pathology examination is consistent with small cell carcinoma. Procedure Code(s) Only:
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