Initial Learning Experience for Electromagnetic Navigation Bronchoscopy: A Surgeon’s Experience while Introducing the Navigation Technology in Pulmonary Lesion Diagnosis

Diagnosing peripheral pulmonary lesions using a traditional bronchoscope is difficult. Reports on the learning experience for Veran’s SPiN electromagnetic navigation bronchoscopy (ENB) for the diagnosis of pulmonary lesions are limited. We aimed to evaluate the skills developed by trainees who underwent Veran ENB learning in a clinical setting. We retrospectively examined the data of patients who had undergone Veran ENB to guide instruments through the airways to a target lesion for biopsy or localization from November 2019 to March 2022. In total, 23 patients, including 16 with solid lesions (69.6%), 4 with pure ground-glass opacity (17.4%), and 3 with mixed (13.0%) were included. The median largest diameter of the pulmonary lesions was 2.7 ± 1.8 cm, whereas the median distance from the pleural surface to the edge of the pulmonary lesion in its shortest path was 1.9 ± 1.6 cm. Most lesions in this cohort had a positive air bronchus sign (69.6%). The mean procedure time for a young thoracic surgeon was longer after 10 cases of operation (45.6 ± 13.4 vs. 33.8 ± 9.2 min, P = 0.027). There were no complications reported related to the procedure. ENB is a safe and less invasive method for tissue diagnosis or preoperative localization for patients with pulmonary lesions. However, a young thoracic surgeon in the learning process requires more time to perform ENB. This study provides basic information about the learning experience of trainees while performing the ENB procedure.