Janani Reisenauer1, Michael J Simoff2, Michael A Pritchett3, David E Ost4, Adnan Majid5, Colleen Keyes6, Roberto F Casal4, Mihir S Parikh5, Javier Diaz-Mendoza2, Sebastian Fernandez-Bussy7, Erik E Folch6. 1. Department of Pulmonary Medicine and Thoracic Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: reisenauer.janani@mayo.edu. 2. Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan. 3. Pulmonary Department, Pinehurst Medical Clinic, Pinehurst, North Carolina; Pulmonary Department, FirstHealth Moore Regional Hospital, Pinehurst, North Carolina. 4. Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. Department of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center-Harvard Medical School, Boston, Massachusetts. 6. Department of Pulmonary and Critical Care Medicine, Massachusetts General Hospital-Harvard Medical School, Boston, Massachusetts. 7. Department of Pulmonary Medicine, Mayo Clinic, Jacksonville, Florida.
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.
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; Jennifer D Duke; Ryan Kern; Sebastian Fernandez-Bussy; Eric Edell Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2022-04-23