Navigated bronchoscopy: a technical review.

BACKGROUND: Navigated bronchoscopy uses virtual 3-dimensional lung model visualizations created from preoperative computed tomography images often in synchronization with the video bronchoscope to guide a tool to peripheral lesions. Navigated bronchoscopy has developed fast since the introduction of virtual bronchoscopy with integrated electromagnetic sensors in the late 1990s. The purposes of the review are to give an overview and update of the technological components of navigated bronchoscopy, an assessment of its clinical usefulness, and a brief assessment of the commercial platforms for navigated bronchoscopy. METHODS: We performed a literature search with relevant keywords to navigation and bronchoscopy and iterated on the reference lists of relevant papers, with emphasis on the last 5 years. RESULTS: The paper presents an overview of the components necessary for performing navigated bronchoscopy, assessment of the diagnostic accuracy of different approaches, and an analysis of the commercial systems. We were able to identify 4 commercial platforms and 9 research and development groups with considerable activity in the field. Finally, on the basis of our findings and our own experience, we provide a discussion on navigated bronchoscopy with focus on the next steps of development. CONCLUSIONS: The literature review showed that the peripheral diagnostic accuracy has improved using navigated bronchoscopy compared with traditional bronchoscopy. We believe that there is room for improvement in the diagnostic success rate by further refinement of methods, approaches, and tools used in navigated bronchoscopy.

Navigated laparoscopic ultrasound in abdominal soft tissue surgery: technological overview and perspectives.

PURPOSE: Two-dimensinal laparoscopic ultrasound (LUS) is commonly used for many laparoscopic procedures, but 3D LUS and navigation technology are not conventional tools in the clinic. Navigated LUS can help the user understand and interpret the ultrasound images in relation to the laparoscopic view and preoperative images. When combined with information from MRI or CT, navigated LUS has the potential to provide information about anatomic shifts during the procedure. In this paper, we present an overview of the ongoing technological research and development related to LUS combined with navigation technology, The purpose of this overview is threefold: (1) an introduction for those new to the field of navigated LUS; (2) an overview for those working in the field and; and (3) as a reference for those searching for literature on technological developments related to navigation in ultrasound-guided laparoscopic surgery. METHODS: Databases were searched to identify relevant publications from the last 10 years. RESULTS: We were able to identify 18 key papers in the area of navigated LUS for the abdomen, originating from about 10-11 groups. We present the literature overview, including descriptions of our own experience in the field, and a discussion of the important clinical and technological aspects related to navigated LUS. CONCLUSIONS: LUS integrated with miniaturized tracking technology is likely to play an important role in guiding future laparoscopic surgery.