ArticleSurgical endoscopy2026
The application of CT-free electromagnetic navigation-guided percutaneous puncture localization of pulmonary nodules.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe accurate localization of small pulmonary nodules remains a significant challenge in thoracic surgery, particularly for lesions that are invisible, impalpable. This study aimed to evaluate the feasibility and safety of a novel CT-free electromagnetic navigation-guided percutaneous puncture (ENPP) technique for intraoperative localization of pulmonary nodules. STUDY
designA single-arm, prospective clinical study was conducted at our hospital, between July and December 2024. Patients with pulmonary nodules ≤ 20 mm who were scheduled for thoracoscopic wedge resection were enrolled. Preoperatively, a computed tomography scan was performed to acquire imaging data for three-dimensional trajectory planning using an electromagnetic navigation system. After induction of general anesthesia in the operating room, percutaneous puncture localization was performed under real-time electromagnetic tracking guidance, followed by immediate thoracoscopic wedge resection. Localization success rate, localization accuracy, procedure time, complications and pathological outcomes were analyzed.
resultsA total of 31 patients (mean age: 53.3 ± 12.7 years; 51.6% male) were enrolled. One-time puncture success rate was 100% (31/31), and overall localization success rate was 93.5% (29/31). The mean puncture time was 2.5 ± 0.5 min. The mean nodule size was 0.85 ± 0.26 cm, with a mean distance of 1.00 ± 0.40 cm from the pleura. The mean distance between the needle tip and the nodule was 0.51 ± 0.50 cm. All patients underwent successful uniportal thoracoscopic wedge resection with R0. No major complications such as pneumothorax, hemorrhage, or air embolism occurred.
conclusionsCT-free ENPP is a safe and workflow-efficient localization technique for small peripheral pulmonary nodules. This technique minimizes radiation exposure, reduces patient discomfort, and enhances intraoperative efficiency.
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