Lung cancer is the number one cancer in the world, but for decades doctors faced a dilemma: they could see a suspicious spot on a patient’s lungs but couldn’t reach it to perform a biopsy.
“Historically, more than half of the nodules are found far into the narrow periphery of the lungs,” says Rafael Alba Yunen, MD, medical director of pulmonary medicine at Southeast Georgia Health System and a pulmonologist at Southeast of Georgia Physician Associates-Pulmonary Medicine. He is triple certified in pulmonology, internal medicine and intensive care medicine.
Although most small tumors are benign, there’s no way to tell without a biopsy, which involves removing a small piece of tissue from the suspected spot or lump. The tissue cells are then examined under a microscope to detect cancer or other diseases.
Being able to diagnose lung nodules early is especially important for Georgians. According to the Georgia Department of Public Health, lung and bronchial cancer rates in the state are higher than the national average.
One of the most advanced and accurate ways to perform biopsies is robot-assisted bronchoscopy, a minimally invasive technology now available to the Southeast Georgia Health System. The Ion robotic system allows doctors to biopsy the smallest and most difficult to reach nodules with high precision and in complete safety. Ion was developed by the same company that launched the da Vinci surgical robot system.
An ion bronchoscopy is performed on an outpatient basis while the patient is under general anesthesia. During bronchoscopy, the doctor guides a small, ultra-thin catheter through the patient’s airway to the suspected nodule. Using a controller, the doctor navigates the catheter, which can move 180 degrees in all directions and reach all 18 segments of the lung. To further improve safety and accuracy, the vision probe and shape detection feature of the catheter provides a clear view of the shape and location of the nodule throughout the procedure. When the doctor reaches the nodule, the catheter is locked in place. Using a thin, flexible biopsy needle that can navigate narrow areas and tight corners, the doctor can take a small sample of lung tissue.
Biopsies with Ion not only extend a doctor’s reach, but they are faster and more accurate, meaning patients are less likely to need a repeat procedure.
“Robotic bronchoscopes are small and incredibly flexible. It helps me as a doctor because I can offer answers to someone with a small, hard to reach nodule. It’s a tool that I didn’t have just a year ago. I’ve practiced long enough to recognize a milestone in pulmonary medicine, and that’s it,” says Charles W. Callender, MD, board-certified pulmonologist at Southeast Georgia Physician Associates-Pulmonary Medicine.
There are no pain receptors in the lungs, so the procedure is painless, although patients may experience a sore throat from the anesthesia process.
According to David Sudduth, MD, board-certified pulmonologist at Southeast Georgia Physician Associates-Pulmonary Medicine. “Ion bronchoscopies are safer and more accurate because the robot provides unprecedented stability throughout the procedure. It offers a high degree of sensitivity for nodules at the extreme periphery of the lung.
As with any surgery, there are risks, including bleeding, infection, and lung collapse. However, because the ion bronchoscope is smaller and more flexible than traditional technologies, complication rates are lower. Alba Yunen praises Ion’s excellent safety profile, citing a study from the Sloan Kettering Memorial Cancer Center showing a complication rate of just 3%. “These rates will continue to decline over time,” says Alba Yunen.
He is excited about Ion’s ability to diagnose lung cancer early. Citing again the Sloan Kettering study, he adds: “The diagnostic yield was over 80%.
Ion complements existing healthcare system robotic technologies, which include the CyberKnife® M6 with MLC technology for the treatment of cancerous and non-cancerous tumors, including lung cancer; the da Vinci® for bariatric, general, gynecological and urological surgical pathologies; MAKOplasty® for partial and total hip and knee prostheses; and ROSA® for total knee arthroplasty.
Acquiring the Ion robot required a significant investment, but doctors say Ion’s potential to save lives is well worth the financial commitment. “I appreciate that the healthcare system is at the forefront of this technology,” adds Callender.
For Alba Yunen, Ion highlights the health system’s commitment to advancing health care. “Our community deserves nothing less when it comes to fighting the world’s number one cancer.”
The Southeastern Georgia Physician Associates-Pulmonary Medicine has offices in Brunswick, St. Marys and Jesup. To make an appointment, call 912-466-5504. For more information about Ion, visit sghs.org/pulmonology.
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