P170. Feasibility of Dye Localization with Robotic Bronchoscopy Before Surgical Resection: A Multicenter Retrospective Analysis
Presented During: Thoracic Poster Session II
Northwestern University Feinberg School of Medicine
Chicago, IL
United States - Contact Me
Samuel S. Kim MD is an Associate Professor of Surgery, Associate Program Director for CT Surgery Residency in the Canning Thoracic Institute, the Division of Thoracic Surgery, Feinberg Northwestern School of Medicine. He serves as the Director of Robotic Surgery and Lung Nodule Program at the Northwestern Medical Center.
Sunday, May 4, 2025: 9:00 AM - 4:00 PM
Seattle Convention Center | Summit
Room: Poster Area, Exhibit Hall
Description
Objective:
Small subpleural lung nodules are often challenging to localize during minimally invasive thoracic surgery. This study evaluated the feasibility of dye localization using the robotic bronchoscopy system to help localize the lesion in anticipation of resection from a multi-institution experience.
Methods:
Consecutive patients undergoing surgical resection of lung nodules with the aid of dye localization using robotic bronchoscopy between 8/7/2020 and 10/5/2022 from three different institutions were included in the study. The IRB approved this work, and informed consent was waived due to the study's retrospective nature. Clinico-demographic and operative and post-operative outcome data were obtained retrospectively using a prospectively maintained database.
Results:
Surgical resections were performed on 288 patients with 318 lung nodules. The mean diameter of lung nodules was 14 mm, with 40.7% of nodules located deeper than 10 mm from the pleura (Table 1). The dye injection was successful in all cases, with 0% procedure termination. The median dye marking procedure time was 29 minutes, including cases where a biopsy was performed in addition to dye marking, and the median operative time was 125 minutes. The dye was visible during resection in 98.6% of lesions. All procedures were performed via a minimally invasive approach. Wedge resections were performed on 176 nodules (55.3%), and segmentectomies and lobectomies were performed on 103 (32.4%) and 39 (12.3%) nodules, respectively. No intra-operative complications related to the dye localization were reported, with a median length of hospitalization of 1.2 days. All lung nodules intended for treatment were resected. The pathology of the nodule consisted of 195 (61.3%) non-small cell lung cancer, 15 carcinoids, 45 metastatic cancer, 51 benign, and 12 others.
Conclusion:
Dye localization of lung nodules using robotic bronchoscopy appears to be a safe and effective method of identifying the location of small subpleural nodules that can facilitate local resection with minimal added operative time.
Authors
Emily Cerier (1), Patrick Ross (2), Luis Herrera (3), Juan Escalon (3), Ali Jiwani (3), Austin Chang (1), Ankit Bharat (1), Samuel Kim (1)
Institutions
(1) Northwestern University Feinberg School of Medicine, Chicago, IL, (2) Main Line Health System, Wayne, PA, (3) Orlando Health, Orlando, FL
Small subpleural lung nodules are often challenging to localize during minimally invasive thoracic surgery. This study evaluated the feasibility of dye localization using the robotic bronchoscopy system to help localize the lesion in anticipation of resection from a multi-institution experience.
Methods:
Consecutive patients undergoing surgical resection of lung nodules with the aid of dye localization using robotic bronchoscopy between 8/7/2020 and 10/5/2022 from three different institutions were included in the study. The IRB approved this work, and informed consent was waived due to the study's retrospective nature. Clinico-demographic and operative and post-operative outcome data were obtained retrospectively using a prospectively maintained database.
Results:
Surgical resections were performed on 288 patients with 318 lung nodules. The mean diameter of lung nodules was 14 mm, with 40.7% of nodules located deeper than 10 mm from the pleura (Table 1). The dye injection was successful in all cases, with 0% procedure termination. The median dye marking procedure time was 29 minutes, including cases where a biopsy was performed in addition to dye marking, and the median operative time was 125 minutes. The dye was visible during resection in 98.6% of lesions. All procedures were performed via a minimally invasive approach. Wedge resections were performed on 176 nodules (55.3%), and segmentectomies and lobectomies were performed on 103 (32.4%) and 39 (12.3%) nodules, respectively. No intra-operative complications related to the dye localization were reported, with a median length of hospitalization of 1.2 days. All lung nodules intended for treatment were resected. The pathology of the nodule consisted of 195 (61.3%) non-small cell lung cancer, 15 carcinoids, 45 metastatic cancer, 51 benign, and 12 others.
Conclusion:
Dye localization of lung nodules using robotic bronchoscopy appears to be a safe and effective method of identifying the location of small subpleural nodules that can facilitate local resection with minimal added operative time.
Authors
Emily Cerier (1), Patrick Ross (2), Luis Herrera (3), Juan Escalon (3), Ali Jiwani (3), Austin Chang (1), Ankit Bharat (1), Samuel Kim (1)
Institutions
(1) Northwestern University Feinberg School of Medicine, Chicago, IL, (2) Main Line Health System, Wayne, PA, (3) Orlando Health, Orlando, FL