2019
DOI: 10.1055/s-0038-1676964 View full text |Buy / Rent full text
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Abstract: Small pulmonary lesions can be difficult to localize during video-assisted thoracoscopic surgery. Electromagnetic navigation bronchoscopy (ENB) dye marking of the lesion, particularly when guided by cone beam computed tomography in the hybrid operating room (HOR), is an emerging approach. However, issues with confirmation of dye injection and intraoperative visualization of the colored dye can be unpredictable and challenging. To address these uncertainties, we present our technique of ENB dye marking localiza… Show more

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“…To aid subsequent VATS identification of the lesion, the needle is advanced to a subpleural location under fluoroscopy, and 0.3 mL of triple contrast is injected (equal volumes of iohexol imaging contrast, methylene blue, and indocyanine green) ( Video 1 ). 1 Subsequently, the extended working channel is retracted to the desired deep margin distance from the lesion as measured on CBCT images, where a SuperLock (Medtronic, Minneapolis, Minn) gold-nitinol coil fiducial marker is placed, with its position confirmed by CBCT ( Figure 2 and Video 2 ).
Figure 1 Cone beam computed tomography on 3 planes in the hybrid operating room demonstrates accurate positioning of electromagnetic navigation bronchoscopy-guided needle tip in close proximity to the left upper lobe lung nodule.
…”
Section: Technique Descriptionmentioning
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“…To aid subsequent VATS identification of the lesion, the needle is advanced to a subpleural location under fluoroscopy, and 0.3 mL of triple contrast is injected (equal volumes of iohexol imaging contrast, methylene blue, and indocyanine green) ( Video 1 ). 1 Subsequently, the extended working channel is retracted to the desired deep margin distance from the lesion as measured on CBCT images, where a SuperLock (Medtronic, Minneapolis, Minn) gold-nitinol coil fiducial marker is placed, with its position confirmed by CBCT ( Figure 2 and Video 2 ).
Figure 1 Cone beam computed tomography on 3 planes in the hybrid operating room demonstrates accurate positioning of electromagnetic navigation bronchoscopy-guided needle tip in close proximity to the left upper lobe lung nodule.
…”
Section: Technique Descriptionmentioning
“…To further expand the success rate of dye-marking, we recently develop a triple contrast dye-marking technique via ENB approach in the hybrid OR (15). The regimen includes the mixture of standard iohexol contrast, methylene blue, and ICG.…”
Section: Enb-guided Dye/contrast Labeling For Assisting Pulmonary Resmentioning
“…Meanwhile, microwave energy produces a larger and more predictable ablation zone, as it is minimally affected by impedance and has less heat-sink effects (11). Building upon our institute's experience in lung nodule dye-marking and biopsy via electromagnetic navigation bronchoscopy (ENB) (13,14), we identified a selected group of cases which are suitable for bronchoscopic transbronchial microwave ablation under ENB guidance. Being one of the first centres to perform ENB microwave ablation in clinical setting, we retrospectively analyze data from the first cohort of patients who had completed the procedure.…”
Section: Introductionmentioning