Electromagnetic Navigational Bronchoscopy - An Overview

What Is Electromagnetic Navigational Bronchoscopy?

Electromagnetic navigational bronchoscopy (ENB) is a medical procedure that employs electromagnetic technology similar to GPS to facilitate the examination of the pulmonary system. The procedure is characterized by enhanced accuracy compared to a conventional bronchoscopy, enabling it to access a broader range of lung regions. During an endobronchial procedure (ENB), a bronchoscope, which is a lengthy and flexible tube equipped with an illuminating source at its end, is inserted through the oral cavity of an individual and advanced into the pulmonary system to scrutinize any anomalous regions, commonly referred to as nodules. During this medical procedure, it is also possible to extract biopsies, small samples of bodily tissue, from the internal regions of the lungs to ascertain the necessity of additional treatment.

What Are the Indications for Electromagnetic Navigational Bronchoscopy?

Electromagnetic navigation refers to the utilization of electromagnetic fields for navigation purposes. Bronchoscopy is deemed to be medically necessary for any of the subsequent indications:

• Individuals presenting with a pulmonary nodule that raises suspicion and cannot be accessed using standard methods, such as those located in the outer regions of the lung, or when standard methods have proven ineffective.

• Individuals with a solitary pulmonary nodule that exhibits a high level of suspicion are at an unacceptable risk for undergoing a more invasive diagnostic procedure due to conditions such as bullous lung disease or diffuse emphysema.

• Individuals with a known lung lesion(s) and a concurrent diagnosis of cancer, where further investigation of the lung lesion is necessary to determine the stage of the primary tumor and subsequently influence the treatment plan.

• Placement of fiducial markers in individuals who are not suitable candidates for surgical intervention but have chosen to undergo radiation therapy.

Who Addresses the Eligibility Criteria for an ENB Procedure?

ENB has the potential to be utilized across a diverse patient population. This event encompasses individuals who experience compromised lung function or have undergone cancer surgery, chemotherapy, or radiation therapy.

What Is the Procedure for Electromagnetic Navigation Bronchoscopy?

Advanced bronchoscopy, called navigational bronchoscopy, also known as electromagnetic navigation bronchoscopy or an ENB treatment, is carried out utilizing the most recent technology and functions like GPS.

A bronchoscope, which is a small, flexible tube, is inserted into the patient's airway and lungs during the surgery. The end of the bronchoscope contains a video camera with a bright light so the doctor can carefully examine the airway and take comprehensive pictures of any anomalies. Once the tube is in position, equipment with specific designs can be introduced using three-dimensional electromagnetic guidance to collect a tissue sample for analysis.

With the precision and accuracy provided by ENB technology, they can introduce equipment to biopsy and stage lesions in even the tiniest lung lesions at the farthest reaches of the lungs. They can also set markers to direct radiation oncologists and thoracic surgeons to the location of the cancer if necessary.

What Are the Advantages of the Procedure?

• Enhanced Detection and Enhanced Access: Allows even the smallest lesions to be detected and biopsied in the most inaccessible regions of the lungs.

• Diagnosed Earlier: This can facilitate earlier lung cancer diagnosis.

• Improves Clinical Decision-Making: This enables the physician to identify a tumor's precise stage and genetic characteristics and develop a highly individualized treatment plan for each patient.

• Reduces Potential for Complications: Reduces the risk of collapsed lung (pneumothorax) compared to conventional bronchoscopy and CAT-scan guided transthoracic needle biopsies.

• Surgical Intervention Is No Longer Necessary: With navigational bronchoscopy, there is typically no need for an invasive needle or surgical biopsy, which can cause complications and pain.

What Are the Potential Side Effects?

Following the completion of the procedure, it is typical to encounter certain adverse effects, which are outlined below:

• Fatigue.

• A common symptom experienced by individuals is a sore throat, which typically exhibits improvement within a few days. It is advisable to consider using over-the-counter pain relief medication to alleviate associated discomfort.

• A cough that excites a minor quantity of blood, which is expected to cease within a few days.

• Low blood pressure, also known as hypotension, typically exhibits improvement following the consumption of fluids.

Just promptly contact the surgical day unit if there are concerns regarding the quantity of blood being expected or if the patient experiences any of the subsequent symptoms:

• There is a notable escalation in the sensation of breathlessness.

• Expelling stomach contents through the mouth through vomiting or being sick.

• A fever is defined as a body temperature of 38 degrees Celsius or higher.

What Are the Complications?

An epidural nerve block (ENB) administration is typically considered a safe and uncomplicated medical intervention. Nevertheless, similar to any medical intervention, this procedure has potential complications. Minor complications that may arise following an ethmoidal nerve block (ENB) procedure encompass potential dental damage.

• A chest infection due to early mobility.

• A transient constriction of the air passages, known as bronchospasm, can result in symptoms such as coughing and wheezing.

Major complications following an endoscopic nasal biopsy (ENB) are infrequent and encompass:

• A pneumothorax, commonly referred to as a collapsed lung, may necessitate an extended hospital stay for the insertion of a chest drain.

What Are the Risks of the Procedure?

Following the administration of the ENB procedure, patients will be closely monitored until they have regained sufficient consciousness to be discharged and returned to their residence. There can be certain risks in this procedure, such as the following:

• The prevailing risk factor most frequently observed is pneumothorax, characterized by the collapse of the lung, with an incidence ranging among patients.

• After undergoing the electromagnetic navigation bronchoscopy (ENB) procedure, it is possible to encounter mild symptoms such as a sore throat, hoarseness, or cough.

• If an individual experiences chest pain or a heightened sense of breathlessness, it is imperative to seek medical attention from a healthcare professional promptly.

Conclusion

The diagnostic modality known as electromagnetic navigation bronchoscopy is experiencing growing acceptance. There is a shortage of solid evidence supporting the technique's efficacy, and its role within the diagnostic algorithm of PPLs is still being determined. The expense associated with implementing ENB is a significant limitation, particularly given its status as a relatively recent technological advancement. Ongoing advancements in hardware and software are being pursued to enhance the effectiveness of diagnostic procedures and improve the usability of these technologies. However, it is crucial to each innovation for individual assessment and evaluation.

Despite the challenges, including the associated high cost, the navigational capability of electromagnetic navigation bronchoscopy (ENB) presents the possibility of broader clinical applicability, encompassing both diagnostic and therapeutic aspects, beyond what can be achieved with traditional bronchoscopy.