HCA Healthcare UK completes first single-anaesthetic ION guided robotic resection in UK independent sector

• HCA UK’s London Bridge Hospital completes Ion-guided coil placement for Stage 1 lung cancer, followed by immediate robotic surgery.
• The integrated approach avoided prolonged surveillance, reduced procedures, and enabled lung sparing surgery.
• This case occurred alongside new research from HCA UK, which found 31% of lung nodules under 10mm were malignant, higher than predicted by established risk models, which inform national guidelines.

HCA Healthcare UK’s London Bridge Hospital has completed a first of its kind combined lung procedure in UK private healthcare, integrating robotic navigational bronchoscopy using the Ion Endoluminal System (Ion) followed by a robotic lung resection using a Da Vinci Xi robot under a single anaesthetic.

The combined approach was used in the care of a patient diagnosed with two cancerous lung nodules, with one lung nodule being non-solid and difficult to locate. Using Ion’s ability to reach and precisely mark small nodules in traditionally hard to access areas of the lung, the clinical team was able to perform Ion guided coil placement to localise the nodule, followed immediately by robotic surgical resection, avoiding staged procedures.

Lung nodules are usually detected through lung cancer screening programmes, cancer surveillance and incidental imaging. Many are small, located in the outer regions of the lung, and present both diagnostic and surgical challenges. Historically, this has often led to periods of ‘watch and wait’, which can be an anxious time for patients.

Ion, which HCA UK pioneered the use of in Europe outside clinical trials, allows clinicians to reach small peripheral nodules with greater precision and accuracy, supporting faster diagnosis and a quicker start to appropriate treatment. When combined with robotic lung resection, it opens the door to more integrated, patient centred pathways that prioritise accuracy, speed and preservation of lung tissue.

The seamlessly sequenced procedure was performed by Professor George Santis, Consultant in Respiratory Medicine and Mr Andrea Bille, Consultant Thoracic Surgeon at HCA UK’s London Bridge Hospital. Professor Santis used the robotic-assisted Ion system to locate and mark the non-solid nodule with sub-millimetre precision. The patient then moved directly to theatre, where Mr Bille used the da Vinci Xi robotic system to guide a precise, tissue-sparing resection. 

By undergoing a single anaesthetic rather than two separate procedures, the physical burden of surgery and anaesthesia was reduced for the patient. Ion’s precision also meant that less lung tissue needed to be removed, supporting preservation of long term respiratory function.

The case sits within a wider body of clinical research generated through HCA Healthcare UK’s Ion programme. Professor Santis evaluated the outcome of Ion Robotic Navigation Bronchoscopy in sampling 258 lung nodules in 238 patients between October 2023 and October 2025.¹

Among nodules with a median size of 7mm, 31% were malignant, and 20% were early-stage lung cancers, a materially higher proportion than predicted by commonly used risk stratification tools, including the Brock score. The median Brock score for these nodules was 5.4%, meaning many were incorrectly classified as low risk at the time of assessment.

Current guidelines tend to recommend surveillance rather than sampling for nodules below 8mm. This data suggests that in a significant proportion of cases, that approach may be delaying cancer diagnosis at an early stage, when cure if treated would be very likely.

Mr Andrea Bille, Consultant Thoracic Surgeon at London Bridge Hospital, said:

“At London Bridge Hospital, we are continually looking at how we can use advanced technology to deliver the best care for our patients. Combining robotic bronchoscopy with robotic surgery allows us to treat very small lung nodules with exceptional accuracy while preserving as much healthy lung as possible. Not only does this benefit the patient, but for insurers and corporate health partners, a single, integrated pathway can also mean faster diagnosis and treatment, quicker recovery, and fewer procedures - helping reduce the overall cost of care. We are proud to be leading this level of innovation in the independent sector.”

Professor George Santis, Consultant in Respiratory Medicine at HCA UK’s London Bridge Hospital, said: 

“Our experience with Ion has been incredibly exciting from both a clinical and research perspective. It is giving us new insight into the behaviour of small lung nodules allowing us to rethink how these patients are managed. Our recent research found that lung cancer was more common in small nodules than current models predicted, which should inform guidelines on nodule management, so that more people with suspected lung cancer are diagnosed and treated swiftly.”

This private sector first reflects HCA UK’s continued investment in robotic technology, clinical research and integrated cancer care. 

¹ Preston, R., Routledge, T., Santis, G. (4th  March 2026). Prospective evaluation of Robotic Navigation Bronchoscopy in the diagnosis and management of low-risk lung nodules [Poster presentation]. British Thoracic Oncology Group Annual Conference, Edinburgh.