Robotic Bronchoscopy

What is robotic bronchoscopy?

Lung cancer often starts in the outer regions of the lung. Because nodules are so small, early lung cancers that form in the deep parts of the lung are hard to reach to make a diagnosis. To address this challenge, the lung specialists at Main Line Health use robotic bronchoscopy to diagnose small nodules that are suspicious for lung cancer.

This new approach to bronchoscopy allows physicians to safely and precisely navigate a thin, flexible catheter (tube) deep into the lung to access areas that have been hard to reach with other forms of bronchoscopy. Through the tube, physicians can biopsy (collect) a piece of the nodule to test it for the presence of cancer.

Robotic bronchoscopy benefits patients whether or not a lung nodule turns out to be cancer:

• If a nodule is diagnosed as cancerous, finding it early allows for earlier treatment than has been possible with other forms of bronchoscopy
• If a nodule is benign (not cancerous), the patient is spared unnecessary cancer treatment, including surgery, and can receive treatment appropriate for the cause of the nodule

The lung team at Main Line Health has been able to accurately diagnose small, difficult to reach lung nodules in more than 90% of patients who undergo robotic bronchoscopy. The tool has allowed the team to reach any point in the lung and to diagnose lesions less than a quarter inch.

Same-day diagnosis and treatment of lung cancer

Most lung nodules are not cancer, but some are. For this reason, it is important to get a diagnosis if a lung nodule raises concern about lung cancer. Robotic bronchoscopy has made it possible for same-day minimally invasive diagnosis and treatment of lung nodules that prove to be cancer.

During the same procedure, robotic bronchoscopy helps your doctor navigate to a nodule to biopsy a sample of the nodule tissue, which is then tested for cancer. If cancer is present and the patient consented to treatment, your care team can offer one of two minimally invasive treatments while the patient is under anesthesia:

• Robotic surgery, which involves tiny incisions in the chest and removal of the portion of the lung where the cancer is located.
• Pulsed electric field (PEF) ablation, a new (as of September 2024), nonsurgical treatment in which high-voltage electricity is delivered directly to the tumor during robotic bronchoscopy. The electricity perforates the cell membranes in the treated tissue, killing the cancer cells without damaging healthy surrounding tissue.

The treatment option that is chosen depends on the size of the tumor and other factors.

At Main Line Health, robotic bronchoscopy is used by interventional pulmonologists and thoracic surgeons, who often work together to diagnose and treat lung cancer. Since 2020, the lung team at Main Line Health has been using robotic bronchoscopy to improve the care of patients with lung nodules that prove to be cancer. This new technology is helping the team reach their goal of diagnosing and treating more lung cancers at an early stage.

Early diagnosis and treatment starts with finding lung nodules

Main Line Health has two programs devoted to detecting lung cancer at an early stage, when treatment is most effective. Both programs focus on finding lung nodules (abnormal growths in the lung) that might be an early cancer.

• The Lung Screening Program involves a yearly low-dose CT scan of the lungs to check for lung nodules. This program is for people with risk factors for lung cancer, such as a history of smoking.
• The Lung Nodule Program involves monitoring people who have had a lung nodule found incidentally on the chest or abdominal imaging done for another reason.