Robotic bronchoscopy – Mayo Clinic


In patients that have pulmonary nodules
that are worrisome for lung cancer that might be enlarging over time or have
shown to be enlarging over time biopsying those nodules is important to get a diagnosis. I have been doing bronchoscopy for over 20 years. I didn’t
think I would see robotic-assisted bronchoscopy actually in my career. In
the past we’ve been using navigational technologies to access those nodules or
to try to get close to biopsying those nodules. The problems with the
technology of the past is that the scopes were too big. The tools were not
good enough to stop the scope from flexing into a segmental airway so now
we have robotic bronchoscopy allowing us much better precision, much better
control in the airway, much better anatomical alignment for the physician
actually driving the scope. We’re actually driving the scope with a gaming
controller and we’re able to steer in any segmental airway that we want to. The optics now are amazing and then the ability to have them displayed on a
high-resolution monitor. And so we are seeing things we’ve never seen before
and the vision is excellent. I’m sure 10 years from now this is going to be
standard and everybody’s going to have robotic bronchoscopy. And some people are still wondering you know, where its applicability really lies, but for us
it’s allowing us to take the lung back. Rather than having a CT guided biopsy
we’re able to get things from you know natural orifice. So pulmonary nodules can really be anywhere and sometimes they’re actually
outside the airway. But sometimes they’re inside the airway now that we actually
have real vision and a smaller bronchoscope that can be driven with
precision into these small airways, we are seeing more things than we’ve seen
before. We are seeing these nodules that are either in the airway or
they’re abutting the airway causing a little bit of an indentation of the
airway. We’re able to then target our needle to that indentation so that we
know we’re in that nodule. We’re placing the target on the CAT scan and then the
robotic platform is helping us get to that target that we’ve placed based on
an individualized patient’s CAT scan. We’re actually transposing the
navigational system, the robotic system with the CT scan of that particular
patient so the patient’s individualized CT scan is inputted into our planning
software for the robotic assisted bronchoscopy allowing us to go to
exactly the targeted airway we need to go. So it’s much like driving upwards
from a tree trunk into the tree. We want to make sure that we are at the target
because this is important not only for diagnosis and tissue acquisition in the
detection and treatment planning for lung cancer, but also in the future it’s
going to lead the way to tumor or nodule ablation where maybe somebody isn’t a
candidate to have surgery and they have a lung cancer, and we can go right to
that nodule and deliver some sort of therapy to shrink or get rid of the
nodule. You have to be very detail-oriented because the setup is
critical because if you think about it, when you’re doing the navigation the robots not telling us where to go, we’re telling the robot where to go
and so if our navigation and our targets are not set correctly, which we do, and if
we’re not driving correctly, we’re not going to get to the target. Each
sample that we take we actually have a person in the room that is trained in
cytology and pathology that will look at that sample under the microscope to
let us know if we’re in truly the right place and then we will continue taking a
lot of sample because these days especially in lung cancer, it is not just
about getting a diagnosis anymore. It’s now we need to get more and more tissue
to assess molecular characteristics of a particular tumor type so that
immunotherapy or personalized chemotherapy, those sorts of decisions,
can be made based upon the molecular profiling of a specific tumor. So the
benefits to the patient are to hopefully avoid procedures that are more invasive
that they didn’t need and ultimately to not have surgery for something that
isn’t a cancer that they didn’t need surgery for to diagnose. We are happy to
be pioneers and really being on the forefront of new technology and new
technology that we can bring to patients and really to help improve the detection
and diagnosis of lung cancer.

3 thoughts on “Robotic bronchoscopy – Mayo Clinic

  1. I miss these kind of videos from you. Don’t get me wrong, your newer stuff is great!!! I just love and appreciate your work! Hope you’re well, also i am trying to make similar videos like!!!! #THCBSpotlights

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