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Robot-Assisted Lung Biopsies in Clinical Trial

The opportunity to cure cases of lung cancer would be "vastly improved" by using robots, experts have said.

Doctors at the Royal Brompton Hospital and St Bartholomew's Hospital are using a robotics-assisted bronchoscopy system as part of a clinical trial.

The Ion Endoluminal System (Ion) was developed by technology company Intuitive. Its manoeuvrable robotic catheter is inserted into the patient via their throat using an endotracheal tube, allowing clinicians to access hard-to-reach areas of the lung and remove biopsies with greater precision.

"Precision and Stability"

Kelvin Lau, consultant thoracic surgeon for St Bartholomew's Hospital, said: "Current biopsy techniques carry risk and are not always accurate, and many patients end up waiting for a repeat scan. The uncertainty of the wait causes anxiety and could allow a cancer to grow and spread. With this shape-sensing robotic technology, I have the precision and stability to lock onto a very small lung nodule and obtain an accurate biopsy quickly and safely. This could transform early diagnosis and treatment, reduce the need for repeat scans and treat lung cancer earlier."

In June, the Government announced plans to roll-out a new lung cancer screening programme in England. Under the scheme, patients aged 55 to 74 with a history of smoking will be offered screenings. It is hoped the move will detect lung cancer earlier in 9000 people.

Mr Lau said that while the UK "is leading the world" in lung cancer screening, "only some of the lung nodules identified during screening are cancerous and need treatment".

Technique Could Improve Survival Rates

Professor Pallav Shah, consultant respiratory physician based at Royal Brompton Hospital, said the new technology is "transformative" as it allows doctors to detect smaller cancerous lung nodules, increasing a patient's survival rate. "When we see patients with cancerous lung nodules of more than 30mm, their five-year survival rate is around 68%, but if we are able to detect these nodules at a smaller size, when they are less than 10mm in size, we are looking at a 92% survival rate.

"This new technology is transformative for us as clinicians because it allows us to access and biopsy nodules of less than 10mm in size in difficult to reach areas of the lungs. The chance of a cure for these patients is therefore vastly improved."

Prof Shah added: "The expanding national lung cancer screening programme in England will increase the number of suspicious nodules detected on CT scans at an earlier stage which will need to be biopsied to determine a diagnosis.

"We know that an earlier diagnosis of lung cancer leads to significantly improved outcomes for our patients."

Dr Oliver Wagner, vice president and medical officer of endoluminal at Intuitive, said: "Lung cancer represents a worldwide health crisis, characterised by distressing survival rates, even after surgical intervention. Within Europe, the UK has emerged as a pioneering force in transforming the clinical outcomes for individuals diagnosed with lung cancer.

"We are in full support of early nodule lung detection and diagnosis and our aim is to bring about a positive transformation in the care pathways for lung cancer, ultimately leading to improved prognosis and well-being of patients."

Marianne Baker, research information manager at Cancer Research UK, commented: "The treatment landscape of lung cancer has been transformed over the last decade and it's exciting to see new diagnostic strategies coming through the pipeline for this hard-to-treat disease. Ultimately, research like this can bring us closer to a world where more people live longer, better lives, free from the fear of cancer."

Last month, the Royal College of Surgeons of England published a guide on robotics-assisted surgery, detailing how the technology could make operations more efficient and help free-up NHS beds.

The document outlined "significant advantages" of using robots in surgery, including reduced post-op pain, fewer blood transfusions, more efficient use of anaesthetics, and shorter hospital stays for patients. For more news, follow Medscape on  Facebook Twitter Instagram, and  YouTube