Topics/Interventional Pulmonary MedicineBronchoscopically Placed Dye Marking for Minimally Invasive Thoracic Surgery: A Surgeon’s PerspectiveSpeicher, James E. MD; Bowling, Mark R. MD; Anciano, Carlos J. MDAuthor Information Department of Cardiovascular Sciences, East Carolina University Brody School of Medicine, Greenville, NC Disclosure: M.R.B. is a consultant for Biodesix Inc. and Medtronic. C.J.A. is a consultant for Medtronic. J.E.S. declares that there is no conflicts of interest. Address correspondence to: James E. Speicher, MD, 115 Heart Dr., East Carolina University Brody School of Medicine, Greenville, NC 27834. E-mail: [email protected]. Clinical Pulmonary Medicine: November 2017 - Volume 24 - Issue 6 - p 239-249 doi: 10.1097/CPM.0000000000000232 Buy Metrics Abstract Small and nonsolid peripheral lung lesions pose a difficult diagnostic problem for surgeons and pulmonologists. Utilizing electromagnetic navigation bronchoscopy with dye marking of these lesions may improve the ability of the surgeon to resect via minimally invasive means. The authors present the rationale behind the use of dye marking via navigation bronchoscopy as well as their preferred method and case examples to demonstrate the technique. In addition, a systematic literature search was performed in PubMed using the terms “navigation bronchoscopy,” “dye marking,” and “lung nodules,” and a literature review performed of the results. The authors demonstrate the use of electromagnetic navigation bronchoscopy with methylene blue dye marking of peripheral small and nonsolid lung lesions as a way of accurately marking nodules to improve ease of resection. In addition, 10 retrospective case series were reviewed with a total of 257 patients and 276 nodules. Success rates of marking and resection of the lesion in question ranged from 79% to 100%, with an average of 95%. Low complication rates and no significant pneumothoraces or hemothoraces were reported. Electromagnetic navigation bronchoscopy-guided dye marking of small and nonsolid peripheral lung nodules is a safe and accurate way of marking these difficult to find lesions. Utilizing these techniques improves the surgeon’s ability to resect complex lesions with minimal potential downside. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.