Planning and marking small nodules for surgery

Video-assisted thoracic surgery (VATS) of small and non-visible pulmonary nodules is nowadays a real challenge for thoracic surgeons. Traditional approaches are no longer admissible for day a day surgery, as VATS is elective option for most cases. In this situation, preoperative planning of techniques to assure nodule finding results of paramount importance. In this issue we will discuss transthoracic procedures, electromagnetic navigation bronchoscopy and hybrid operating rooms and their role to make surgery feasible. We also discuss its pros and cons, indications and needings. According to the literature and authors opinion, different techniques are nowadays available to identify small pulmonary nodules. Whether electromagnetic navigation bronchoscopy and hybrid operating rooms are available should be the preferred techniques.