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Related Concept Videos

Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

Endoscopic Studies I: Bronchoscopy and Thoracoscopy

Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due to...

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Tumour Localisation With ICG-Soaked Embolisation Coils Without Robotic Bronchoscopy: First German Experience.

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Indocyanine green (ICG)-soaked coils precisely mark lung nodules for minimally invasive surgery. This fluorescence-guided technique using ultrathin bronchoscopy is safe and effective, even without robotic systems.

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ICGVATSfluorescenceindocyanine greenlung sparring sublobar resection

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Area of Science:

  • Thoracic Surgery
  • Pulmonary Medicine
  • Medical Imaging

Background:

  • Accurate localization of small or non-palpable pulmonary lesions is crucial for successful minimally invasive resection.
  • Indocyanine green (ICG)-soaked embolization coil placement is an emerging fluorescence-guided marking method, typically applied to subpleural nodules.

Purpose of the Study:

  • To present the first case series in Germany using ICG-soaked embolization coils for pulmonary lesion localization via ultrathin bronchoscopy.
  • To evaluate the safety, reproducibility, and effectiveness of this technique for diverse lesion locations, including non-subpleural nodules.

Main Methods:

  • Four patients underwent ICG-soaked embolization coil placement using ultrathin bronchoscopy, a cytology brush catheter, and cone beam CT (CBCT) guidance without robotic bronchoscopy.
  • Lesions were confirmed with radial endobronchial ultrasound (EBUS), and resection was performed via uniportal video-assisted thoracoscopic surgery (VATS).

Main Results:

  • Marking was successful in all four cases without complications.
  • One patient received dual-coil placement for a non-subpleural lesion, enabling precise anatomical resection.
  • Histologies included squamous cell carcinoma, adenocarcinoma, hamartoma, and typical carcinoid, with all patients achieving R0 resections.

Conclusions:

  • ICG-soaked coil placement via ultrathin bronchoscopy is a safe, reproducible, and effective localization technique for pulmonary lesions.
  • This method is feasible in centers without robotic navigation systems and expands the applicability of fluorescence-guided thoracic surgery to more centrally located nodules.