London Bridge Hospital, part of HCA UK, first in Europe to offer robotic assisted lung biopsy to patients

Today HCA Healthcare UK (HCA UK), launches its new state-of-the-art Ion Endoluminal System (Ion), which could help transform early diagnosis of suspected lung cancer.  Based at their London Bridge Hospital, they are the first hospital in Europe, outside of ongoing clinical studies, to offer the robotic-assisted technology.

Lung cancer is the most common cause of cancer death in the UK¹ and more than two-thirds of cases are diagnosed at a late stage of progression.² In addition, lung nodules are also often found in patients with other types of cancer that spread to the lungs, which makes accurate and prompt diagnosis essential to optimising their care.

In the past treatment pathways would often require a ‘watch and wait’ period which could last for months, leaving patients with the stress of not knowing whether their lung nodule is cancerous or not.

Lung nodules are often found in tight spaces and narrow airways that may be hard to reach with traditional bronchoscopy techniques, which leaves two options for patients: monitor and re-scan the lung after several months of anxious “watchful waiting” or start treatment without full clarity on whether the nodule is cancerous or benign, which can involve invasive treatment for the patient.

If a clinician finds a small mass or nodule on a patient’s lung, they may recommend a lung biopsy to determine a cancer diagnosis. Ion is a new system used to perform robotic-assisted bronchoscopy – which enables a lung biopsy. Operated by specialists at London Bridge Hospital, Ion’s thin and maneuverable catheter enables clinicians to reach small nodules in all 18 segments of the lung, offering greater precision and accuracy compared to existing manual bronchoscopy techniques.

With Ion, created by Intuitive, the makers of the da Vinci robotic-assisted surgical system, patients could receive diagnosis faster, have immediate reassurance or start appropriate treatment quicker.

In future it is hoped that appropriate patients may be able to have surgery using the da Vinci surgical system to remove their tumour on the same-day as receiving their lung cancer diagnosis – increasing the opportunity to treat the cancer early.

Outside of trials taking place in the NHS, London Bridge Hospital is the first and only provider in Europe to offer this advanced technology to patients in a clinical setting. More than 400 systems are already installed in U.S. hospitals.

Ion’s ability to access the hard-to-reach areas of the lung means that it can reach small nodules (which are more likely to represent earlier stage disease) in traditionally challenging locations. This could be impactful, as the five-year survival rate for patients with cancerous lung nodules of more than 30mm is around 68%, but detecting these nodules and intervening when they are at a smaller size, less than 10mm, means a 92% survival rate.³

Ion’s shape-sensing robotic-assisted technology gives consultants greater reach, flexibility and precision, compared to traditional manual biopsy methods. During the procedure, the consultant inserts an ultra-thin catheter into the airway, which can move 180° in all directions. Biopsies are then taken, with the Ion system holding the catheter in place for precise biopsy tool placement.

Giving clinicians greater access to the outer peripheries of the lung may mean patients won’t have to wait months for additional invasive tests and procedures.

Janene Madden, CEO of London Bridge Hospital, part of HCA UK, says:

"At London Bridge Hospital, we are committed to providing patients with the highest quality care, using the most advanced technology. Which is why we are delighted to be the first hospital in Europe to embrace Ion, offering a new option to patients and clinicians of getting an accurate lung biopsy and faster results. The future potential of Ion is incredibly exciting - we hope in time to be making same day biopsy and removal of cancerous lung tumours possible – which may reduce the waiting time for patients and enable them to receive further treatment if it is needed even more quickly."

Mr Tom Routledge, Consultant Thoracic Surgeon at London Bridge Hospital, part of HCA UK, said:

"The new Ion system provides our patients with gold standard technology, at the pinnacle of innovation. This really will be revolutionary for patients with suspicious nodules in the lung, offering more accurate results quicker. Suspected lung cancer cases can mean a period of ‘watchful waiting’, leading to increased worry for patients - Ion gives us an alternative option. We’re also excited about the fact that Ion allows us to reach areas of the lung which have been hard to reach before, which is both clinically game-changing and transformative for patient wellbeing, due to reduced wait times."

Professor George Santis, Consultant Respiratory Physician at London Bridge Hospital, part of HCA UK, said:

"Ion’s robotic navigation bronchoscopy will revolutionise the management of lung nodules. This common clinical challenge is relevant not only to lung cancers but other cancers too. This innovative technology will radically change patient care for the better."

Situated within London Bridge Hospital, the new Ion system further strengthens the hospital’s capability and commitment in the area of robotic-assisted cancer surgeries.

Whether the nodule is found to be cancerous or benign, patients can immediately access HCA UK’s network of hospitals and patient care centres – should they require surgery, treatment or follow-up care after the biopsy. This includes access to other leading robotic technologies housed at HCA UK, and its expert consultants including specialists in Oncology.

This is the latest example of HCA UK’s continued investment in pioneering robotic-assisted technology. HCA UK is the largest provider of robotic assisted surgery in Europe within the private sector.

References

^1.Cancer Research UK. Lung Cancer Mortality. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer#heading-One Last accessed: August 2023

^2.Cancer Research UK. Proportion of Cancer Cases By Stage at Diagnosis, 2020. Available at: https://crukcancerintelligence.shinyapps.io/EarlyDiagnosis/ Last accessed: August 2023

^3. Kay FU, Kandathil A, Batra K, Saboo SS, Abbara S, Rajiah P. Revisions to the Tumor, Node, Metastasis staging of lung cancer (8th edition): Rationale, radiologic findings and clinical implications. World J Radiol 2017; 9(6): 269-279 [PMID: 28717413 DOI: 10.4329/wjr.v9.i6.269]