2022 World Conference on Lung Cancer (ePosters)-EP02.03-007. Seeds of Gold. Triple Contrast Marking in Hybrid Operative Room for All-in One Diagnostic and Therapeutic Precision Surgery

EP02.03-007. Seeds of Gold. Triple Contrast Marking in Hybrid Operative Room for All-in One Diagnostic and Therapeutic Precision Surgery

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The study conducted by a team of researchers aimed to evaluate the effectiveness of a triple contrast technique for locating non-palpable lung lesions during video-assisted thoracic surgery (VATS) wedge resection. The technique involved the simultaneous use of three different marking systems: gold seed Biomarc, methylene blue, and indocyanine green (ICG). <br /><br />Nine patients with non-palpable lung lesions underwent lesional targeting in a hybrid operating room (H-OR) using the triple contrast technique. The patients were placed in a lateral decubitus position, and the lesion was identified using intraoperative targeting. The positioning of the gold seed and the correct intralesional needle positioning were verified using intraoperative fluoroscopy. <br /><br />The results showed that the gold seed marking was visualized correctly in all patients, except for one in which it was dislocated. Methylene blue was visible in seven patients, while in two patients, it appeared to be non-visible, and in two patients, a blue-lake effect was observed. The ICG was not visualized in three patients. <br /><br />Minimally invasive wedge resections were performed in all nine patients, and they were sent for a frozen section pathological report. The report revealed a diagnosis of lung adenocarcinoma in six patients who underwent VATS lobectomy, while three patients were diagnosed with inflammatory lung lesions. In 80% of the cases, the preoperative core biopsy was consistent with the final pathological report. <br /><br />The study findings suggest that using a multiple marking approach with different techniques in a hybrid operating room can help locate hard-to-find lung lesions during VATS resection, thus reducing the need for conversion to thoracotomy. However, further research is needed to optimize the technique and improve the visibility of methylene blue and ICG.

Asset Subtitle

Francesco Guerrera

Meta Tag

Speaker Francesco Guerrera

Topic Early Stage Non-small Cell Lung Cancer - Surgery

Keywords

triple contrast technique

non-palpable lung lesions

video-assisted thoracic surgery

VATS wedge resection

gold seed Biomarc

methylene blue

indocyanine green

hybrid operating room

intraoperative targeting

intraoperative fluoroscopy