A new role for single-use bronchoscopes in helping detect lung cancer

Bronchoscopy Procedure

How the Power of Single-Use Enhances Robotic Bronchoscopy

“The precision of the robot allows the tube to navigate tight right turns and hard-to-reach areas of the lungs in order to obtain a biopsy of the lung tissue."

Lung cancer is crafty. It can skulk for years before revealing itself through signs or symptoms.

The Centers for Disease Control and Prevention (CDC) identifies lung cancer as the third most-common type in the U.S. It also kills more people here and globally — both men and women — than any other form of cancer.

Yet when detected early, it’s very treatable.

That’s why an annual screening of those at highest risk — including people over 50 who smoked a pack of cigarettes a day for 20 years or a half pack a day for 40 years — is so important.

Lung cancer is projected to rise globally with increasing tobacco-smoking rates, according to research published in Contemporary Oncology.

Yale Hospital is one facility using robotic bronchoscopy to better reach smaller parts of the lungs. Doctors there use a controller at a console to operate a robotic arm which guides the thin, flexible bronchoscope though the narrow airways.

“The precision of the robot allows the tube to navigate tight right turns and hard-to-reach areas of the lungs in order to obtain a biopsy of the lung tissue,” said Dr. Christopher Morton, an interventional pulmonologist, in a Yale Medicine post and video.

Typically, a regular bronchoscopy is done — with a reusable scope or a single-use version such as Ambu offers — ahead of a robotic bronchoscopy being performed.


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Those procedures may be followed with an endobronchial ultrasound (EBUS) if it is necessary to sample lymph nodes around the lung and airways where cancer can hide, to help determine if it has spread. Neither standard bronchoscopy nor robotic bronchoscopy can collect those samples. The EBUS scope’s ultrasound at its tip enables doctors to see the lymph nodes to gather a sample.

Adding the Single-Use Advantage to Robotic Bronchoscopy

About 750 U.S. hospitals have robots that can perform bronchoscopy. One such version, made by Noah Medical, is called the Galaxy System and equipped with a single-use robot for navigated bronchoscopy.

Most pulmonologists perform a surveillance bronchoscopy before screening for lung cancer with robotic bronchoscopy, and they may use one again following the procedure. Thoracic surgeons also typically perform a bronchoscopy before they use a robot to treat cancer surgically.

Single-use bronchoscopes simplify that work because they are always available, sterile from the package and never require reprocessing or repairs.

Among its single-use devices, Ambu also offers a novel double-lumen tube that can eliminate the need for additional bronchoscopy to confirm initial placement or to monitor positioning as the patient’s body shifts.

In a recent video, Dr. Javier D. Lasala, a cardiothoracic anesthesiologist in Houston, Texas, and an Ambu consultant, demonstrated performing a robotic right lower lobe lobectomy on a lung cancer patient using Ambu VivaSight 2 DLT​.

Using this single-use double lumen tube with real-time visualization of the airway enabled Lasala to establish and maintain lung isolation without needing to perform additional bronchoscopy to confirm tube placement or tube repositioning.

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