Related Experiment Video
Updated: Oct 19, 2026
Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
Extended reality-assisted localization of lung nodules in a hybrid operating room: A prospective study
Chih-Hsiang Chang1, Ning Chien2, Hsien-Yuan Hsieh3
1Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Objective:
To evaluate the feasibility, accuracy, and safety of a novel extended reality-assisted percutaneous localization technique in a hybrid operating room for patients with small pulmonary nodules.
Methods:
In this prospective, single-arm study, 20 adult patients scheduled for video-assisted thoracoscopic surgery sublobar resection for peripheral pulmonary nodules (2 cm or less) were enrolled. Participants underwent extended reality-guided percutaneous dye localization under general anesthesia. Patient-specific 3-dimensional holographic models were registered using optical markers to guide needle insertion, followed by confirmatory cone-beam computed tomography. The primary outcomes were technical accuracy and procedural safety.
Results:
The extended reality-assisted technique achieved a 90% technical success rate. The mean localization error was 7.9 mm in the intention-to-treat population. The procedure was efficient, with a median localization time of 13.5 minutes and a median of 1 confirmatory cone-beam computed tomography scan. The complication rate was 5%, involving a single case of pneumothorax; no intrapulmonary hemorrhage or air embolism occurred.
Conclusions:
Extended reality-assisted percutaneous localization in a hybrid operating room is feasible and safe, demonstrating acceptable accuracy for small pulmonary nodules. This approach may streamline surgical workflow by enabling continuous needle advancement and reducing repetitive interruptions compared with conventional cone-beam computed tomography guidance.
