Robot-Assisted Bronchoscopy for Identification of Lung Nodules During Minimally Invasive Pulmonary Resection

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Robotics

Background:

• Minimally invasive surgical (MIS) resection of small pulmonary nodules presents identification challenges.
• Standard bronchoscopy with electromagnetic navigation has been used, but robot-assisted bronchoscopy offers enhanced capabilities for lesion biopsy.
• Robot-assisted bronchoscopy (RAB) is a newer technology with demonstrated utility in accessing small lung lesions.

Purpose of the Study:

• To evaluate the safety and efficacy of robot-assisted bronchoscopy with dye marking for guiding MIS pulmonary resection.
• To assess the success rate of dye visualization in identifying target nodules for sublobar resection.
• To determine if this technique avoids the need for more invasive procedures like thoracotomy or lobectomy.

Main Methods:

• Thirty patients with peripheral pulmonary nodules underwent RAB prior to MIS resection.
• Indocyanine green or methylene blue dye was injected directly into the target nodule.
• Success was defined by successful dye visualization enabling sublobar resection without thoracotomy or lobectomy.

Main Results:

• The overall success rate for dye-guided resection was 83.3% (25 of 30 patients).
• The median nodule size was 9 mm, and median distance from the pleura was 5 mm.
• No complications were associated with the robot-assisted bronchoscopy procedure; pathology confirmed cancer or benign disease.

Conclusions:

• Robot-assisted bronchoscopy combined with dye marking is a safe and effective method for identifying small peripheral pulmonary nodules.
• This technique facilitates precise localization, enabling successful sublobar resection in most cases.
• The procedure avoids the necessity of thoracotomy or lobectomy, enhancing minimally invasive approaches.