Dual outline of navigating utensil in thoracoscopic segmentectomy: a new method.

Thoracoscopic segmentectomy requires an adequate surgical margin; however, only a few reports have described the procedure of how to maintain a constant distance from the tumour. We here suggest a novel simple method to secure an adequate surgical margin: the dual outline of navigating utensil in thoracoscopic segmentectomy (DONUTS) method. We used a DONUTS indicator sheet produced from a 1.5-mm thick absorbed sheet with a proper diameter to secure an adequate surgical margin. The indicator sheet, which was affixed to the pleura, indicated a new resection line. With this new line, an additional excision was performed in addition to conventional segmentectomy. The clinical records of 9 patients who underwent treatment with the DONUTS method between August 2011 and December 2013 were retrospectively reviewed. No postoperative complications of loco-regional recurrence were observed over a mean period of 20.3 months.