Abstract
The development of imaging technology has recently facilitated uniportal minimally-invasive thoracic surgery techniques. Cone-beam computed tomography (CBCT) shows promising results in visualizing the target lesion and its surrounding critical anatomy, with an average error of less than 2 mm. The hybrid operation room (OR), which integrates CBCT and the OR, is capable of providing unparalleled real-time imaging of the patient, which can be incorporated into electromagnetic navigation bronchoscopic marking of pulmonary lesion to reduce the likelihood of navigation tool malpositioning and, hence increase procedural accuracy. Furthermore, implantation of hookwires or microcoils that are widely used to localize pulmonary lesions can proceed in the hybrid suite, eliminating the common complications and discomfort associated with the conventional workflow carried out in the radiology suite. Implantation displacement leading to localization failure can also be reduced, and sublobar resection can be performed without resecting a larger area of parenchyma than desired. This hybrid OR provides a one-stop concept for simultaneously diagnosing and managing tiny pulmonary lesions.
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References
Zhao ZR, Lau RWH, Ng CSH. Hybrid theater and uniportal video-assisted thoracic surgery: the perfect match for lung nodule localization. Thorac Surg Clin. 2017;27:347–55.
Schafer S, Nithiananthan S, Mirota DJ, Uneri A, Stayman JW, Zbijewski W, et al. Mobile C-arm cone-beam CT for guidance of spine surgery: image quality, radiation dose, and integration with interventional guidance. Med Phys. 2011;38:4563–74.
Uneri A, Nithiananthan S, Schafer S, Otake Y, Stayman JW, Kleinszig G, et al. Deformable registration of the inflated and deflated lung in cone-beam CT-guided thoracic surgery: initial investigation of a combined model- and image-driven approach. Med Phys. 2013;40:017501.
Zhao ZR, Lau RW, Yu PS, Wong RH, Ng CS. Image-guided localization of small lung nodules in video-assisted thoracic surgery. J Thorac Dis. 2016;8:S731–7.
Advanced Multimodality Image Guided Operating (AMIGO). 2016. http://www.brighamandwomens.org/research/amigo/default.aspx. Accessed 1 Sep 2018.
Ng CS, Man Chu C, Kwok MW, Yim AP, Wong RH. Hybrid DynaCT scan-guided localization single-port lobectomy. [corrected]. Chest. 2015;147:e76–8.
Ng CS, Yu SC, Lau RW, Yim AP. Hybrid DynaCT-guided electromagnetic navigational bronchoscopic biopsy†. Eur J Cardiothorac Surg. 2016;49:i87–8.
Eberhardt R, Anantham D, Herth F, Feller-Kopman D, Ernst A. Electromagnetic navigation diagnostic bronchoscopy in peripheral lung lesions. Chest. 2007;131:1800–5.
Makris D, Scherpereel A, Leroy S, Bouchindhomme B, Faivre JB, Remy J, et al. Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions. Eur Respir J. 2007;29:1187–92.
Ng CSH, Zhao Z, Long H, Lau RWH. Electromagnetic navigation bronchoscopy triple contrast dye marking for lung nodule localization. Thorac Cardiovasc Surg. 2019 . doi: https://doi.org/10.1055/s-0038-1676964
Kidane B, Yasufuku K. Advances in image-guided thoracic surgery. Thorac Surg Clin. 2016;26:129–38.
Ng CS, Hui JW, Wong RH. Minimizing single-port access in video-assisted wedge resection, with a hookwire. Asian Cardiovasc Thorac Ann. 2013;21:114–5.
Zhao ZR, Lau RW, Ng CS. Hybrid theatre and alternative localization techniques in conventional and single-port video-assisted thoracoscopic surgery. J Thorac Dis. 2016;8:S319–27.
Gill RR, Zheng Y, Barlow JS, Jayender J, Girard EE, Hartigan PM, et al. Image-guided video assisted thoracoscopic surgery (iVATS) – phase I-II clinical trial. J Surg Oncol. 2015;112:18–25.
Yu PSY, Man Chu C, Lau RWH, Wan IYP, Underwood MJ, Yu SCH, et al. Video-assisted thoracic surgery for tiny pulmonary nodules with real-time image guidance in the hybrid theatre: the initial experience. J Thorac Dis. 2018;10:2933–9.
Ng CSH, Chu CM, Lo CK, Lau RWH. Hybrid operating room Dyna-computed tomography combined image-guided electromagnetic navigation bronchoscopy dye marking and hookwire localization video-assisted thoracic surgery metastasectomy. Interact Cardiovasc Thorac Surg. 2018;26:338–40.
Zhao ZR, Lau RWH, Ng CSH. Non-intubated video-assisted thoracic surgery: the final frontier? Eur J Cardiothorac Surg. 2016;50:925–6.
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Real-time fluoroscopy in hybrid operating room of methylene blue iodine contrast mixture dye marking injection adjacent to target lesion (lung lesion not well seen on fluoroscopy) showing a classical contrast blush near the end of video (MP4 39665 kb)
Uniportal VATS wedge resection of a right upper lobe lesion precisely dye marked with methylene blue by image-guided electromagnetic navigation bronchoscopy in the hybrid operating room (MP4 347368 kb)
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Zhao, ZR., Ng, C.S.H. (2019). Image-Guided Uniportal VATS in the Hybrid Operating Room. In: Gonzalez-Rivas, D., Ng, C., Rocco, G., D’Amico, T. (eds) Atlas of Uniportal Video Assisted Thoracic Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-13-2604-2_39
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DOI: https://doi.org/10.1007/978-981-13-2604-2_39
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