Early lung cancer & GGN patients
Patients requiring tumor localization
Multiple/bilateral lung tumor cases
Benign or early-stage malignant tumors
Domestic & international thoracic trainees
Led by Yin-Kai Chao at Chang Gung Memorial Hospital, image-guided VATS (iVATS) has been developed in the hybrid OR since 2016 and is recognized as a world-leading demonstration center. Unlike conventional CT-room localization requiring patient transfer and 2–3 hours of procedural risk time, this team performs localization using Zeego/Cios Spin 3D C-arm systems in the same OR and patient position. With personalized route planning and marker selection (ICG, microcoil, dual markers), the team achieved an average localization time of 16.5 minutes, risk time of 13.7 minutes, 98.5% success rate, 6.6% pneumothorax rate, and 3-day hospital stay across 460 patients with 509 tumors. The group accomplished several world-first milestones, including the first Zeego + ENB dual-marker case, first Cios Spin CT-localization publication, first iVATS comparison trial (NCT04974632), first 3D C-arm trial (NCT03395964), and first dual-marker iVATS paper. They have published 14 papers, including 8 in top-20% journals, ranking first worldwide in top-tier surgical journal output in this field. In 2021, the team partnered with Siemens Healthineers to establish the world’s only image-guided thoracic surgery reference site, training physicians from 13 countries worldwide.
World-first 3D C-arm lung localization trial
World-first Cios spin CT-localization paper
Personalized routing/marker selection
Same OR, same patient position
Dual marker (Coil+ICG) workflow
World's only image-guided thoracic reference site
460 patients served
509 lung tumors resected
>500 hybrid-OR procedures
12 domestic physicians trained
33 intl physicians trained (13 countries)
14 invited domestic talks
Risk time 13.7 min (world #1)
Avg localization 16.5 min
Success rate 98.5%
Pneumothorax 6.6% (below peers)
Tumor size 0.85 cm (fine handling)
Hospital stay 3 days
Standardized decision flow avoids collision
Published standardized workflow book
Multi-tumor simultaneous needle insertion
Reduces radiation dose
Fluorescent staining protocols
Personalized markers reduce unplanned thoracotomy
High patient satisfaction
Early-stage lung cancer 5-yr survival 99.7%
Family-member appreciation
Recognized industry training center
Image-guided VATS reference site launched
Promotional video on Siemens global website
World #1 paper output (14 papers, 41.2%)
8 top-20% journal papers (62%)
40 international invited talks
Trained 33 intl physicians from 13 countries
Siemens Healthineers global-unique reference site
Leads comparison with top iVATS centers
Enables precision sublobar resection for lung cancer
99.7% 5-yr survival in early-stage lung cancer
Hosted Taiwan's first iVATS conference
Hosted first intl iVATS meeting
Siemens collaboration on next-gen device
Video teaching breaks through pandemic isolation
