Ion: Technology and Techniques for Shape-sensing Robotic-assisted Bronchoscopy.

Abstract

PURPOSE:

This report describes the Ion Endoluminal System (Intuitive Surgical, Inc, Sunnyvale, CA) and practices for safe and effective use in patients with small peripheral pulmonary nodules (PPNs).

DESCRIPTION:

This shape-sensing robotic-assisted bronchoscopy system allows airway visualization and navigation to reach and biopsy small PPNs through a stable platform. The system provides 3-dimensional mapping and visualization of the airways, a flexible and fully articulating 3.5-mm (outer diameter) catheter, a peripheral vision probe, and system-specific biopsy needles.

EVALUATION:

The Ion Endoluminal System was evaluated in an ongoing prospective, multicenter trial including 241 patients with 270 PPNs (largest mean cardinal measurement, 18.8 ± 6.5 mm). Mean time to register and navigate decreased from 10 minutes in the first 10 cases to 7 minutes in the subsequent cases. Asymptomatic pneumothorax occurred in 8 patients (3.3%), 1 (0.4%) with pigtail catheter placement. Two patients (0.8%) experienced airway bleeding; both cases of bleeding resolved within 5 minutes of tamponade.

CONCLUSIONS:

The Ion Endoluminal System's unique shape-sensing technology can be leveraged to facilitate localization and sampling of PPNs and potentially improve diagnostic accuracy.

• Authors: Janani Reisenauer, Michael J Simoff, Michael A Pritchett, David E Ost, Adnan Majid, Colleen Keyes, Roberto F Casal, Mihir S Parikh, Javier Diaz-Mendoza, Sebastian Fernandez-Bussy, Erik E Folch
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 113 Issue 1 Pg. 308-315 (Jan 2022) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 34370981 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Bronchoscopy (instrumentation, methods)
• Equipment Design
• Female
• Humans
• Male
• Multiple Pulmonary Nodules (surgery)
• Prospective Studies
• Robotic Surgical Procedures (instrumentation)