Ion Robotic Bronchoscopy

What is Ion Robotic Bronchoscopy?

Ion robotic bronchoscopy is an advanced, minimally invasive procedure that allows doctors to examine and biopsy small or hard to reach area of concerns in the lung with high precision. This procedure is performed using a robotic-assisted system that provides greater control and flexibility compared to traditional bronchoscopy.

It utilizes LungGPS™ technology, similar to a car GPS, which creates a roadmap of your lungs based on a CT scan. This roadmap helps the specialist navigate precisely to the lung abnormality (often a nodule).

The procedure is done under general anaesthetic, which means you will be asleep during the procedure.

Why is this procedure performed?

Ion robotic bronchoscopy is used primarily for:

• Diagnosing lung nodules or abnormalities seen on imaging scans.

• Performing biopsies with greater accuracy, reducing the need for repeat procedures.

• Guiding fiducial marker placement, which is a small piece of gold marker to aid future surgery or radiotherapy treatment. This will be discussed with you before the procedure.

• Reducing complications compared to traditional bronchoscopy methods.

• Identifying cancerous or non-cancerous abnormalities earlier, potentially avoiding unnecessary surgery.

What are your benefits and risks?

Benefits:

• Increased precision in reaching lung nodules, including in distant areas.

• Minimally invasive, reducing recovery time.

• Lower risk of complications compared to other biopsy methods.

• Higher success rates in obtaining accurate biopsy samples.

• Allows for marker placement to guide future treatment.

Risk:

• Bleeding at the biopsy site (low risk, usually minor).

• Pneumothorax (collapsed lung), occurring in less than 3% of cases.

• Infection, though this is uncommon.

• Coughing or mild discomfort after the procedure.

• Adverse reaction to sedation or anaesthesia.

• Radiation exposure, as most robotic bronchoscopy procedures are performed under X-ray or CT guidance.

• Heart strain with abnormal heart rhythm in less than 5% of cases.

How does this procedure differ from other biopsy procedures?

Traditional bronchoscopy can only reach the central lung areas, limiting access to small nodules in distant regions. Ion robotic bronchoscopy enables the specialist to navigate deeper into the lungs, reducing the need for more invasive methods like needle biopsy or surgery.

How does Ion Robotic Bronchoscopy work?

Step-by-step guide to Ion Robotic Bronchoscopy

1. A CT scan of your lungs is converted into a 3D roadmap for guidance.
2. A camera scope is inserted through the mouth while you are under general anaesthesia through a flexible tube called the endotracheal tube.
3. Tracking sensors on your chest and a location board under your back assist in real-time navigation.
4. The doctor collects tissue samples for analysis and may place fiducial markers near the nodule for future treatment planning. In some cases, a lung fiducial marker, which is a small gold marker, is placed in the lung to assist with further treatments such as targeted radiation therapy or surgery.
5. A chest X-ray may be taken after the procedure to check for complications.
6. The specialist team may also perform a procedure called endobronchial ultrasound (EBUS) to sample lymph glands in the centre of your chest. This will be discussed with you in clinic or during the consent if the procedure is needed.

How should I prepare for the procedure?

• Your doctor will review your medical history and discuss any necessary tests before the procedure.

• You may be asked to avoid eating or drinking for a few hours before the procedure.

• If you take blood thinners, your doctor will provide specific instructions on whether to stop them before the procedure.

• Arrange for someone to drive you home, as you may feel drowsy from sedation.

What to expect after the procedure?

• You may have a mild sore throat, cough, or a nausea which should resolve within a few days.

• In most cases, a chest X-ray may be performed to check for complications.

• If a biopsy was taken, your doctor will discuss the results with you once they are available.

• If fiducial markers were placed, they will be visible on X-ray but do not need to be removed.

• Most patients can go home the same day and resume normal activities within 24 hours.

Further Information

University Hospital of North Tees

The Respiratory Department
Telephone: 01642 624936
Monday to Friday, 09:00 a.m. to 05:00 p.m.

For general health information, visit www.nhs.uk or call 111 for non-emergency advice.

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