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Updated: Jul 15, 2026
Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
Comparison of learning curves between electromagnetic navigation bronchoscopy and Ion robotic bronchoscopy for
Hongjiang Liu1,2, Hecheng Zhang3, Xiang Tang1,2
1Jiangsu Key Laboratory of Digital Intelligence in Chronic Disease Prevention and Treatment, Thoracic Surgery Laboratory, Xuzhou Medical University, Xuzhou, China.
Background:
Electromagnetic navigation bronchoscopy (ENB) and Ion robotic bronchoscopy are novel, high-precision techniques with low complication rates for the preoperative localization of peripheral pulmonary nodules (PPNs). Their clinical application is largely influenced by the operator's learning curve; however, direct, systematic comparisons of the learning curves between these two techniques are scarce. This study therefore aimed to analyze differences in the learning curves between ENB and Ion robotic bronchoscopy for PPN localization.
Methods:
A retrospective analysis was performed on the perioperative data of 120 patients who underwent preoperative PPN localization (60 consecutive ENB-guided cases and 60 Ion robotic bronchoscopy-guided cases) from September 2024 to June 2025. All procedures were performed by the same thoracic surgeon. The clinical characteristics of the two groups were compared, and the cumulative sum (CUSUM) method was employed to analyze operative time (OT).
Results:
Perioperative comparisons revealed that the ENB group had a significantly shorter OT (17.13 vs. 45.62 min in the Ion group), whereas the Ion group exhibited a higher localization success rate (96.67% vs. 86.67% in the ENB group). CUSUM modeling of OT divided the learning curves into learning and proficiency phases, with inflection points at the 19th procedure for ENB and the 34th for Ion. Further analysis confirmed that the OT during the learning phase was significantly longer than that in the proficiency phase for both groups (P<0.05).
Conclusions:
This study demonstrates that ENB-guided PPN localization has a shorter learning curve than Ion robotic bronchoscopy, while the latter achieves a higher localization success rate.
