Taipei Veterans General Hospital certified as Asia's first electromagnetic navigation center of excellence 

A minimally invasive thoracic surgery team at Taipei Veterans General Hospital (TVGH) has continued to work on exquisite, personalized minimally invasive procedures for pulmonary ground-glass nodules (GGNs), early-stage lung cancer and even some metastatic lung nodules. An electromagnetic navigation system, introduced in 2018, allows for precise localization of lesions in the operating room and has been performed in over 100 cases. The success rate of one-stop precise localization and resection is > 96%; the proportion of surgery needing to change from single-port video-assisted thoracoscopes to double-port thoracoscopes is <5%; the hospital stay is only 2-5 days; the operation time is reduced by 2 hours; the patient's anxiety and post-operative pain index are significantly lowered, which is highly satisfactory. This outstanding research has been published in the Annals of the American Thoracic Society and the European Journal of Cardio-Thoracic Surgery, and the facility was this year certified as the first center of excellence for electromagnetic navigation in Asia.

Director of thoracic surgery Hsu Han-shui (許瀚水) said that low-dose computed tomography (CT) has recently become a gold standard for early detection of lung cancer, which can give early warning when the tumor is still small and in its initial stages. Single-port video-assisted thoracoscopic surgery (VATS) allows the removal of lung tumors with only 2 to 3 days of hospitalization, but all of this is dependent on accurate imaging.

Hsu Po-kuei (徐博奎), a thoracic surgeon at TVGH, pointed out that the hospital’s thoracic surgery division has accumulated thousands of cases of conventional CT localization of lung tumors. On such basis, in a bid to reduce the inconvenience and anxiety of patients who are positioned in the examination room before surgery and then transferred to the operating room, the hospital is the first in 2020 to introduce mobile CT in the operating room, so that clear and high-quality images of the lung can be acquired immediately during surgery, expediting clinical decision-making and assisting in image-guided surgery, including the preoperative small lung tumor localization or tumor ablation in a minimally invasive procedure.

Another technique that assists in the preoperative localization of small lung tumors is the electromagnetic navigation system, which guides the bronchoscope through the intricacies of the bronchial branches to reach the target lesion for localization. It is also possible to reach the target lesion directly from outside the body with a fine needle through the skin as if looking through the skin, which means there are two options available for targeting the same lesion. The technique was developed two years ago and has served more than 100 patients since then. Based on the interviews, patients were highly satisfied with the localization in electromagnetic surgical navigation. The facility’s exceptional performance has been certified and recognized this year as the first electromagnetic navigation center of excellence in Asia.