Lung cancer is among the leading causes of cancer-related death among men and women, and tends to spread quickly. It does not show any symptoms unless it is very advanced, and can silently spread to virtually any part of the body. This makes early screening and treatment critical. Traditionally, when a patient is diagnosed with a suspicious nodule or mass in their lung, they are referred to a pulmonologist, who may perform a lung biopsy to confirm if it is cancerous. If the lung nodule or mass is confirmed to be cancer, the patient may be referred to a thoracic surgeon, who determines if it can be surgically removed. If it can, the patient undergoes another procedure on a separate day that requires additional anesthesia. On average, patients may wait up to three months from the time a nodule or mass is first discovered to when they receive a diagnosis and treatment. Now, a robotic-assisted minimally invasive biopsy platform allows for the diagnosis and removal of a lung cancer mass during one surgery, thus reducing anxiety and unnecessary waiting time for patients.

The Ion Endoluminal Platform by Intuitive Surgical (Silicon Valley, CA, USA) enables the robotic-assisted bronchoscopy procedure by creating a 3D map of the patient’s lungs using a CT scan. The software then generates the safest and most efficient route through the lung to the nodule or mass. Once the route is determined, an ultrathin and ultra-maneuverable catheter is guided to the site of the lung nodule or mass, where it is marked and biopsied with precision and stability. Lymph nodes are also biopsied during the same procedure, using endobronchial ultrasound. The samples are then evaluated on-site. If the lung nodule is determined to be an early-stage cancer, the surgical team uses the same navigational route to mark the area with dye to prepare for its removal. Then, the patient, still asleep, has a second robotic procedure to remove the lung cancer on the same day.

Ion is designed to fit easily into a bronchoscopy suite and integrate with existing technologies. Physical proximity has been taken into account with a design that keeps the surgical team close to the patient’s airways throughout the procedure. Although Ion does not require the use of cone beam CT for nodule biopsy, the system has been designed to be compatible with this technology. Ion leverages existing imaging technologies with radial endobronchial ultrasound (rEBUS), fluoroscopic, virtual, and live views of the lung all unified in a single system. Additionally, Ion’s network connection allows access to system data. The data dashboard utilizes this automatically collected system data and provides it back to the user. The surgical team can see their data in one place. The dashboard provides a detailed view of system utilization and procedure data. The surgical team can view information on their case times, instruments and accessories utilization, the target nodule location in the lung, as well as the size of a lesion.

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