Step-by-step lung nodule localization in the hybrid operating room using a double marking technique with Lipiodol and indocyanine green.

This video tutorial presents a step-by-step description of percutaneous lung nodule localization performed in a hybrid operating room using indocyanine green and Lipiodol under cone-beam computed tomography guidance. Preoperative localization is indicated when the surgeon anticipates difficulty identifying a pulmonary nodule by digital palpation during video-assisted thoracoscopic surgery. The combined use of indocyanine green fluorescence and fluoroscopy allows accurate intraoperative detection and confirmation of adequate resection margins.