AIM (Anticipate/Adjust, Image, Manage) to Prevent Bleeding During Robotically-Assisted Bronchoscopic Ablation

Area of Science:

• Interventional Pulmonology
• Minimally Invasive Surgery
• Oncology

Background:

• Lung nodule ablation is an emerging therapeutic option, though not yet standard care.
• While generally safe, bleeding is a recognized complication of lung nodule ablation.
• Robotically assisted bronchoscopic ablation presents a novel approach to treating lung nodules.

Purpose of the Study:

• To present a stepwise strategy for preventing uncontrolled bleeding during robotically assisted bronchoscopic ablation.
• To illustrate the AIM (Anticipate/Adjust, Image, Manage) protocol through case examples.

Main Methods:

• The AIM protocol involves anticipating high-risk structures for bleeding and adjusting the ablation plan.
• Utilizing cone beam CT imaging before and after ablation sessions to screen for bleeding.
• Employing Fogarty balloon occlusion preemptively to manage potential bleeding events.

Main Results:

• The presented cases demonstrate the successful application of the AIM protocol.
• The stepwise approach aims to mitigate the risk of uncontrolled hemorrhage during the procedure.

Conclusions:

• The AIM protocol provides a structured method to enhance safety in robotically assisted bronchoscopic ablation.
• This approach can help select patients benefit from lung nodule ablation while minimizing bleeding complications.