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Evaluation of the ability of the Palpator to detect hidden (occult) lung tumours that cannot be visualized or palpated using the traditional methods of visual inspection, grasper palpation, and VATS ultrasound.
All procedures will be performed with the patient under general anesthesia with single lung ventilation through double-lumen endotracheal intubation. Three to four thoracoports, no larger than 12 mm, will be inserted in the intercostal spaces as needed. After VATS port placement, the pleural cavity will be insufflated with CO2 to a maximum pressure of 8 mm Hg to assist with lung deflation. A standard VATS pleuroscopy will be performed to visually search for the nodule and its position confirmed with sequential assessment using a grasper, the Palpator, the VATS ultrasound probe, and then finger palpation. This will ensure that all patients will have the opportunity to avoid a large thoracotomy if the lesion can't be identified by the Palpator. If the lesion can be detected either visually or by grasper palpation, this information will be recorded, but will be excluded from the analysis of Palpator feasibility.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study arm | Other | All patients will undergo a standard VATS pleuroscopy to visually search for the nodule and its position. Sequential assessment using a grasper, the Palpator, the VATS ultrasound probe, and then finger palpation will be done to detect the nodule. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Palpator | Device | Palpator for tumor localization |
| |
| Grasper |
| Measure | Description | Time Frame |
|---|---|---|
| Tumour detection | The palpator will be declared feasible of it can detect at least 80% of tumours (sensitivity) without the need for a thoracotomy. | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Prevention of thoracotomy | The number of patients undergoing conversion from VATS to open thoracotomy | 1 day |
| Adverse events | Adverse events will be recorded. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Deb Lewis | Contact | 519-685-8500 | 75685 | deb.lewis@lhsc.on.ca |
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| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| D013899 | Thoracic Neoplasms |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
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| ID | Term |
|---|---|
| D014463 | Ultrasonography |
| ID | Term |
|---|---|
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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| Device |
Atraumatic lung grasper |
|
| Ultrasound | Device | VATS ultrasound |
|
| Finger palpation | Other | Palpation of the lung/tumour using the surgeon's finger |
|
| 30 days |
| D012140 |
| Respiratory Tract Diseases |