Discussion:
Although increasingly popular, hybrid ORs are typically associated with single-specialty use. The ability to diagnose and deliver treatment in a single setting is of critical importance. Due to increasing specialization, multiple physician specialties are likely to be involved to achieve this goal.
Given the relatively deep location of the lesion within the RUL, a bronchoscopic approach was initially selected. However, there was a reasonable possibility that the catheter might not approximate the lesion. Therefore, interventional radiology was consulted in advance to provide an alternative approach. Percutaneous PEF energy was delivered successfully without impact on planned surgical resection. This case demonstrates a collaborative approach that establishes a plan of care utilizing different sub-specialties in advance of bringing the patient to the hybrid OR mitigated the likelihood of a non-diagnostic result. Thus, the need for a subsequent procedure and anesthetic was eliminated.