Cleveland Clinic Indian River continues to provide its surgeons with the latest technology to perform procedures with acute precision and accuracy. This is the case with state-of-the-art robotic-assisted bronchoscopy that is revolutionizing the way bronchoscopies are performed.
Pulmonologist Dr. Hermes Velasquez, who performed the first robot-assisted bronchoscopy at Cleveland Clinic Indian River Hospital last July, told Vero Beach 32963 that “the benefits of using robotic technique are three-fold.
“First of all, it allows us to navigate more precisely. Second, we get more reach, allowing us to reach further into the bronchus. And third, it is more stable and once we reach our target spot, we can anchor the device in that position, which makes it more advantageous to start the sampling process for biopsies.
The American Lung Association defines bronchoscopy as a technique used to examine your airways with a small camera positioned at the end of a flexible tube. The camera is connected to a video screen where your doctor can view pictures of the airways. The tube also has a small channel to collect tissue samples from your lung which can be used for disease diagnosis.
With a traditional bronchoscopy, the doctor manipulated the bronchoscopy tube with instruments controlled by his hands. Thanks to the new robotic technology, the doctor still controls the instrument but is able to move the flexible bronchoscopy tube more precisely, allowing him to reach parts of the lung that might have been difficult to reach with the traditional bronchoscopy techniques.
As the doctor controls the robotic system, a 3D map of the patient’s lung is displayed on the computer screen. The map allows the doctor to see exactly where the tube is in the person’s lung and guides the doctor to the nodule.
Robotic-assisted bronchoscopy is performed on eligible patients who are diagnosed with a lung nodule or lung mass and who need to undergo a biopsy to determine if the nodule is cancerous or not.
The outpatient procedure is done under general anesthesia. On the day of the operation, a chest scan will be performed with a special protocol that will serve as a mapping tool. This specific image of your chest is saved on a CD, which in turn is placed in the robotic software. The software will identify the lesions in the scanner and create a visual path for the doctor to follow.
Once the patient is sedated, a flexible tube is inserted into the endotracheal tube. The catheter is then manipulated by a controller operated by the physician. The doctor follows the designated path that is mapped from the CT scan of your lungs leading directly to the nodule.
“The procedure is based on electromagnetic navigation,” Dr. Velasquez said. “A special sensor is placed on the periphery of the patient. These sensors guide the robot with our movement to the precise location where the robot has identified the nodule. We then use additional imaging guidance… Biopsy tools are then used to take samples from the nodule. Using these tools in combination gives us precise precision.
“We have a pathologist on site so as we get the samples we can have the pathologist look at them on a slide and within minutes I can have the input that yes it’s compatible with Cancer or not is not cancerous but may be consistent with other inflammatory conditions.
Or he can say that all he sees is a good lung; then the robot will help guide me to a different position so that I can extract a better sample. This process is called rapid on-site assessment.
If the patient has two or three lesions on the same side of the lung, they can all be biopsied at the same time. Samples cannot be taken from both sides of the lung for safety reasons, but the patient can return for the procedure from the other side at a later date. There is no limit to the number of times a patient can undergo the procedure.
“Our goal is to find lung cancer early in the game and ultimately save lives,” Dr. Velasquez said. “Lung cancer is curable if caught early, but unfortunately most lung cancers are discovered after the curable stage. That’s why it’s so important to get lung cancer screening by CT scan to make sure there are no lesions.By doing so, we can attack the cancer in its early stages.
Since 80% of all lung cancers are smoking-related, the CDC recommends annual screenings for anyone over age 50 who currently smokes or has quit smoking within the past 15 years and has a history of lung cancer. smoking 20 packs a year. To determine your smoking history, multiply the number of packs of cigarettes smoked per day by the number of years of smoking.
Dr. Velasquez completed his medical training at Universidad del Aulia in Maracaibo, Venezuela, and his internship and residency in internal medicine at Jackson Memorial Hospital/University of Miami. He completed a fellowship in pulmonary medicine at Jackson Memorial Hospital in Miami.
Dr. Hermes Velasquez can be reached at his office at Cleveland Clinic’s Indian River Hospital Health and Wellness Center, 3450 11th Court, Vero Beach, or by calling 772-794-5800.