Accurate and Patient-Friendly Intraoperative Lung Nodule Localization Method for Sublobar Resection Using a Hybrid Operating Room

A hybrid operating room (OR) is an OR that uses advanced imaging techniques, such as multidetector computed tomography (CT), cone-beam computed tomography (CBCT), fluorescence imaging and magnetic resonance imaging [1]. Hybrid ORs were originally developed for cardiovascular surgery, but they are now used for many other clinical areas including thoracic surgery, neurosurgery, vascular surgery, urology and orthopaedic surgery. In thoracic surgery, a hybrid OR has been used as an intraoperative localization method for pulmonary nodules that are difficult to identify visually or by finger palpation. Yang et al. [2] reported a feasibility study of single-stage augmented fluoroscopic bronchoscopy localization and thoracoscopic resection of small pulmonary nodules in a hybrid OR. Their localization method had 2 main characteristics: a single-stage procedure performed in a hybrid OR and marking under an augmented fluoroscopic bronchoscopy. Marking is important for localizing small pulmonary nodules that are otherwise difficult to identify intraoperatively, especially subsolid nodules or deep-seated nodules.