Benefits of Electromagnetic Navigational Bronchoscopy for Identifying Pulmonary Nodules for Robotic Resections. 2017

Stevan S Pupovac, and Alexander Chaudhry, and Vijay A Singh

OBJECTIVE The ability to localize pulmonary nodules via the robotic thoracic technique can be challenging at times. This is most evident when nodules are small and/or ground glass in nature. Information regarding methods available to localize these difficult nodules, while maintaining a minimally invasive robotic approach, is limited. METHODS We describe a diagnostic and therapeutic method of combining electromagnetic navigational bronchoscopy with a total minimally invasive robotic approach that identifies these difficult-to-localize pulmonary nodules. The technique entails the use of electromagnetic navigational bronchoscopy to place a pleural dye marker with a subsequent pulmonary resection via a robotic thoracic approach. RESULTS A cohort of 15 patients from August 2014 to December 2015 was reviewed. These patients underwent the combined approach of electromagnetic navigational bronchoscopy followed by a robotic pulmonary resection. Fourteen of the 15 patients had a successful combined procedure, which was confirmed with pathology. The range of the nodules was 0.8 to 2 cm. Methylene blue was used for pleural dye marking. On one occasion, the pleural dye was not able to be deciphered. There were no complications from either the electromagnetic navigational bronchoscopy or robotic portions of the procedure. CONCLUSIONS Pleural dye marking via electromagnetic navigational bronchoscopy can provide an effective method for localizing pulmonary nodules, while maintaining a minimally invasive robotic approach. This tactic allows one to obtain diagnostic tissue more efficiently, while limiting the potential inability to localize a nodule.

UI MeSH Term Description Entries
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D011013 Pneumonectomy The excision of lung tissue including partial or total lung lobectomy. Bronchoscopic Lung Volume Reduction,Endoscopic Lung Volume Reduction,Lung Volume Reduction,Lung Volume Reduction Surgery,Partial Pneumonectomy,Partial Pneumonectomies,Pneumonectomies,Pneumonectomy, Partial,Reduction, Lung Volume,Volume Reduction, Lung
D001999 Bronchoscopy Endoscopic examination, therapy or surgery of the bronchi. Bronchoscopic Surgical Procedures,Surgical Procedures, Bronchoscopic,Bronchoscopic Surgery,Surgery, Bronchoscopic,Bronchoscopic Surgeries,Bronchoscopic Surgical Procedure,Bronchoscopies,Surgeries, Bronchoscopic,Surgical Procedure, Bronchoscopic
D003074 Solitary Pulmonary Nodule A single lung lesion that is characterized by a small round mass of tissue, usually less than 1 cm in diameter, and can be detected by chest radiography. A solitary pulmonary nodule can be associated with neoplasm, tuberculosis, cyst, or other anomalies in the lung, the CHEST WALL, or the PLEURA. Coin Lesion, Pulmonary,Pulmonary Coin Lesion,Pulmonary Nodule, Solitary,Solitary Lung Nodule,Coin Lesions, Pulmonary,Nodule, Solitary Pulmonary,Nodules, Solitary Pulmonary,Pulmonary Coin Lesions,Pulmonary Nodules, Solitary,Solitary Pulmonary Nodules,Lesion, Pulmonary Coin,Lung Nodule, Solitary,Nodule, Solitary Lung,Solitary Lung Nodules
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001706 Biopsy Removal and pathologic examination of specimens from the living body. Biopsies
D015331 Cohort Studies Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. Birth Cohort Studies,Birth Cohort Study,Closed Cohort Studies,Cohort Analysis,Concurrent Studies,Historical Cohort Studies,Incidence Studies,Analysis, Cohort,Cohort Studies, Closed,Cohort Studies, Historical,Studies, Closed Cohort,Studies, Concurrent,Studies, Historical Cohort,Analyses, Cohort,Closed Cohort Study,Cohort Analyses,Cohort Studies, Birth,Cohort Study,Cohort Study, Birth,Cohort Study, Closed,Cohort Study, Historical,Concurrent Study,Historical Cohort Study,Incidence Study,Studies, Birth Cohort,Studies, Cohort,Studies, Incidence,Study, Birth Cohort,Study, Closed Cohort,Study, Cohort,Study, Concurrent,Study, Historical Cohort,Study, Incidence
D055590 Electromagnetic Phenomena Characteristics of ELECTRICITY and magnetism such as charged particles and the properties and behavior of charged particles, and other phenomena related to or associated with electromagnetism. Electrical Concepts,Electromagnetic Concepts,Electrical Phenomena,Electrical Phenomenon,Electromagnetic Phenomenon,Electromagnetics,Concept, Electrical,Concept, Electromagnetic,Concepts, Electrical,Concepts, Electromagnetic,Electrical Concept,Electromagnetic Concept,Electromagnetic Phenomenas,Phenomena, Electrical,Phenomena, Electromagnetic,Phenomenon, Electrical,Phenomenon, Electromagnetic
D065287 Robotic Surgical Procedures Surgical procedures performed remotely using a computer that controls surgical instruments attached to mechanical arms designed to perform the tasks of the surgeon. Robot Surgery,Robot-Assisted Surgery,Robot-Enhanced Procedures,Robot-Enhanced Surgery,Robotic-Assisted Surgery,Surgical Procedures, Robotic,Procedure, Robot-Enhanced,Procedure, Robotic Surgical,Procedures, Robotic Surgical,Robot Assisted Surgery,Robot Enhanced Procedures,Robot Enhanced Surgery,Robot Surgeries,Robot-Assisted Surgeries,Robot-Enhanced Procedure,Robot-Enhanced Surgeries,Robotic Assisted Surgery,Robotic Surgical Procedure,Robotic-Assisted Surgeries,Surgery, Robot,Surgery, Robot-Assisted,Surgery, Robot-Enhanced,Surgery, Robotic-Assisted,Surgical Procedure, Robotic

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