Sant Pau innovates in the extraction of pulmonary nodules

An ovation breaks the silence in the operating theater area of ​​Sant Pau Hospital, in Barcelona.

Oliver Thansan
Oliver Thansan
07 June 2023 Wednesday 11:11
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Sant Pau innovates in the extraction of pulmonary nodules

An ovation breaks the silence in the operating theater area of ​​Sant Pau Hospital, in Barcelona. A team led by Juan Carlos Trujillo, head of Thoracic Surgery, has just performed a pioneering operation in Europe: the detection, marking and extraction of a pulmonary nodule in the same operation.

"What we have done is to simplify the circuit, the fusion in the same act of two techniques that are done separately", explains Dr. Trujillo. "Until now, patients had to come the day before or the same day to have a CT scan and be able to put the radiotracer to mark the pulmonary nodule. Then you had to wait until entering the operating theater to perform the resection."

Using the new technique, with the patient sedated and intubated in the operating room, the entire process is synthesized with the most advanced technologies.

In a first phase, a bronchoscopy is performed with bronchial electromagnetic navigation, which allows access to the pulmonary nodule using a previously planned route, as if it were a GPS. This procedure offers more diagnostic yield than conventional bronchoscopy to detect lesions suspected of malignancy. The next step is the marking of the lesion, in this case, double. "A marking with a fluorescent green dye that will allow the colleagues in thoracic surgery to visualize the injury, and another marking with a radiotracer, which will allow a gamma camera to be used to precisely locate the outline of the injury," explains pulmonologist Virginia Pajares, coordinator of the center's Bronchoscopy unit.

Trujillo will use the Da Vinci robot, "a minimally invasive technique that reduces patient morbidity and mortality and speeds up recovery". Advantages of the new procedure? "We are reducing the morbidity we add to patients with the operation", sums up the surgeon. "We are adding the best quality when it comes to diagnosis and treatment in the same act. The patient does not have to go through a double anaesthesia, he does not have to change areas within the hospital... and at the same time we are sure that it is the best possible treatment".

Enric Gotanegra accepted the proposal to undergo the pioneering procedure. He was operated on on Tuesday, March 21, and on Friday he was already at home. Since then, five similar procedures have been carried out in Sant Pau. "Everything is faster and much less aggressive", explains the patient. Its good condition is proof of the benefits of unifying the phases of therapy and increasing the accuracy of diagnosis and surgery.