التفاصيل البيبلوغرافية
| العنوان: |
Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery. |
| المؤلفون: |
Ghosh S; Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill., Chambers D; Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill., Belanger AR; Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill., Burks AC; Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill., MacRosty C; Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill., Conterato A; Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill., Long J; Section of Thoracic Surgery, Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill., Haithcock B; Section of Thoracic Surgery, Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill., Rivera MP; Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill., Akulian JA; Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill; jason_akulian@med.unc.edu. |
| المصدر: |
Journal of visualized experiments : JoVE [J Vis Exp] 2022 May 04 (183). Date of Electronic Publication: 2022 May 04. |
| نوع المنشور: |
Journal Article; Video-Audio Media |
| اللغة: |
English |
| بيانات الدورية: |
Publisher: MYJoVE Corporation Country of Publication: United States NLM ID: 101313252 Publication Model: Electronic Cited Medium: Internet ISSN: 1940-087X (Electronic) Linking ISSN: 1940087X NLM ISO Abbreviation: J Vis Exp Subsets: MEDLINE |
| أسماء مطبوعة: |
Original Publication: [Boston, Mass. : MYJoVE Corporation, 2006]- |
| مواضيع طبية MeSH: |
Lung Neoplasms*/pathology , Solitary Pulmonary Nodule*/diagnostic imaging , Solitary Pulmonary Nodule*/pathology , Solitary Pulmonary Nodule*/surgery , Thoracic Surgery*, Bronchoscopy/methods ; Electromagnetic Phenomena ; Humans ; Retrospective Studies ; Thoracic Surgery, Video-Assisted/methods |
| مستخلص: |
The increased use of chest computed tomography (CT) has led to an increased detection of pulmonary nodules requiring diagnostic evaluation and/or excision. Many of these nodules are identified and excised via minimally invasive thoracic surgery; however, subcentimeter and subsolid nodules are frequently difficult to identify intra-operatively. This can be mitigated by the use of electromagnetic transthoracic needle localization. This protocol delineates the step-by-step process of electromagnetic localization from the pre-operative period to the postoperative period and is an adaptation of the electromagnetically guided percutaneous biopsy previously described by Arias et al. Pre-operative steps include obtaining a same day CT followed by the generation of a three-dimensional virtual map of the lung. From this map, the target lesion(s) and an entry site are chosen. In the operating room, the virtual reconstruction of the lung is then calibrated with the patient and the electromagnetic navigation platform. The patient is then sedated, intubated, and placed in the lateral decubitus position. Using a sterile technique and visualization from multiple views, the needle is inserted into the chest wall at the prechosen skin entry site and driven down to the target lesion. Dye is then injected into the lesion and, then, continuously during needle withdrawal, creating a tract for visualization intra-operatively. This method has many potential benefits when compared to the CT-guided localization, including a decreased radiation exposure and decreased time between the dye injection and the surgery. Dye diffusion from the pathway occurs over time, thereby limiting intra-operative nodule identification. By decreasing the time to surgery, there is a decrease in wait time for the patient, and less time for dye diffusion to occur, resulting in an improvement in nodule localization. When compared to electromagnetic bronchoscopy, airway architecture is no longer a limitation as the target nodule is accessed via a transparenchymal approach. Details of this procedure are described in a step-by-step fashion. |
| تواريخ الأحداث: |
Date Created: 20220523 Date Completed: 20220525 Latest Revision: 20220620 |
| رمز التحديث: |
20240628 |
| DOI: |
10.3791/58405 |
| PMID: |
35604170 |
| قاعدة البيانات: |
MEDLINE |
