Intraoperative Displacement of a Radiofrequency Identifier Tag into the Proximal Bronchus Requiring Extension of Lung Resection—Report of a Case—

Abstract

Palpation of the lesions is challenging during lung resection for small, deep-seated and ground glass opacity nodules, which often require preoperative localization marking. Radiofrequency identification (RFID), a digital marking technology using a bronchoscope, has clinically been applied in recent years. RFID marking accurately localizes even deep-seated lesions, however, little is known about its complications. Here, we report intraoperative displacement of the tag placed from the airway for the first time. A 71-year-old woman with suspected metastatic lung cancer (an 8-mm nodular shadow in the S10 of the left lung) underwent thoracoscopic wedge resection after RFID-based localization at two sites. We experienced RFID tag displacement in one out of the two tags requiring a wider wedge resection during the surgery than scheduled. The displacement might be caused by shaft wire distortion secondary to gripping with the ring forceps and extrusion with multiple clamping by the endo-staplers during lung resection. Manipulation using ring forceps or multiple clamping by endo-staplers should be avoided in the vicinity of RFID tags during lung resection. A RFID tag should be placed in the peripheral airway near the lesion.