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Robotics program advances lung cancer diagnostics

Courtesy of El Camino Hospital
New robotic tools are extending insight into the peripheral lung.

Innovative techniques highlighted in a new study at El Camino Health found improved precision and accuracy for lung nodule biopsies using the latest in robotics technology.

The Mountain View-based health system continues to advance medicine in diagnosing and treating lung cancer and other conditions through use of the Ion Endoluminal Robotic Bronchoscopy System.

Dr. Ganesh Krishna, medical director of El Camino Health’s interventional pulmonology program, is spearheading the innovative work. He referred to the breakthrough technology as “a game changer.”

“Access to the periphery of the lung has always been challenging to lung doctors,” Krishna said. “Those challenges have been somewhat overcome with new technologies that give us access to the peripheral areas of the lung.”

The new study not only revealed increased access leading to better diagnoses, but also established that side effects were minimal.

“We had zero incidents of significant bleeding, and very low risk of lung collapse at 3.8%, which is much lower than other procedures that are in place now,” Krishna said.

Krishna and his team had high expectations going into the study.

“When we look at the nodule of the biopsy, the median size is less than 2 centimeters,” he said. “The previously established diagnostic accuracy with nodules that are less than 2 centimeters was 51%. Ours was 86%, so that’s clearly well above what has been established before.”

It’s vital to catch lung cancers early. Krishna noted the 65% survival rate of stage 1 or stage 2 cancers over five years.

Cutting-edge tech

Krishna’s study, published last month, details using robotic-assisted navigation bronchoscopy (RANB) combined with cone beam computed tomography (CBCT) to access and assess lung growths or nodules. The study concluded that use of the novel and minimally invasive approach results in more accurate diagnoses for cancerous growths and allows for easier access to nodules in previously hard-to-reach areas of the lungs. Most cancers diagnosed with the technology in the study were early-stage.

“For the past 15 years, I’ve worked to find more sophisticated, noninvasive methods that can speed the process of diagnosing and treating lung cancer,” Krishna said. “Yet again, the way we approach lung cancer is evolving before our eyes. The use of robotic technologies offers a clear path to catch malignant growths sooner and with more precision in order to improve outcomes and cancer survival rates for our patients.”

Minimally invasive

RANB is a minimally invasive approach that leverages the Ion robotic system by Intuitive to reach the outer areas of the lungs for biopsies, where 70% of nodules are found but which are often extremely difficult to access safely.

Intuitive’s technology, which is ultra-thin and highly maneuverable, provides a crucial tool for achieving unprecedented precision for biopsy procedures. Previous methods have been suboptimal in comparison and not consistently accurate, often requiring more than one procedure to confirm a diagnosis. But RANB, combined with CBCT for secondary confirmation, allows doctors to arrive at an accurate diagnosis with only one procedure, and patients are sent home the same day.

In the study, Krishna used this approach on 52 consecutive patients to access and biopsy a total of 59 lung nodules. It is the first paper published in the U.S., and the first in the world, to cover the Ion robotic device and associated results since its 2019 approval by the U.S. Food and Drug Administration.

El Camino Health’s interventional pulmonology is among the leading programs of its kind on the West Coast. In 2019, it became the first program in the world to perform a robotic lung nodule biopsy commercially. El Camino Health is also a regional leader in robotic-assisted surgeries, with its team completing more than 10,000 procedures since 2006.

El Camino Health is currently conducting several pulmonology-related clinical trials through its Taft Center for Clinical Research. For more information, visit elcaminohealth.org/services/clinical-trials/pulmonology.

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