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Updated: Mar 21, 2026
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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
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Electromagnetic Navigation Bronchoscopy for Identifying Lung Nodules for Thoracoscopic Resection
Katy A Marino1, Jennifer L Sullivan1, Benny Weksler1
1Division of Thoracic Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.
The Annals of Thoracic Surgery
|May 14, 2016
Summary
Electromagnetic navigation bronchoscopy with methylene blue marking safely and effectively identifies small pulmonary nodules, enabling minimally invasive resection and avoiding thoracotomy conversion.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Interventional Pulmonology
Background:
- Minimally invasive resection of small pulmonary nodules (<1 cm) is challenging.
- Difficulty in localization often leads to conversion to thoracotomy.
- Electromagnetic navigation bronchoscopy (ENB) offers a potential solution for precise nodule localization.
Purpose of the Study:
- To evaluate the safety and efficacy of ENB-guided methylene blue marking for small pulmonary nodules.
- To assess the impact of this technique on the rate of conversion to thoracotomy during minimally invasive resection.
Main Methods:
- Retrospective review of patients undergoing ENB and minimally invasive resection of pulmonary nodules (2011-2014).
- Nodules <10 mm or <20 mm and >10 mm from pleura were localized and marked with methylene blue.
- Resection was performed immediately after marking.
Main Results:
- 70 patients underwent ENB marking; 97% had one nodule localized.
- Median nodule size was 8 mm; median distance from pleura was 6 mm.
- No conversions to thoracotomy were required; marking success rate was 97.2%.
Conclusions:
- ENB-guided methylene blue marking is a safe and effective method for identifying small pulmonary nodules.
- This technique facilitates minimally invasive resection, reducing the need for thoracotomy.
