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Robotic Bronchoscopy Program

Lung cancer is the third most common cancer in the U.S., but it is the leading cause of cancer-related deaths. The reason is that most lung cancers are diagnosed in late stages of the disease. Hence, early detection is a key for longer survival when lung cancer is only limited to one area of the lung. A diagnosis of lung cancer often begins when a chest X-ray or computed tomography (CT) scan shows a nodule—an area of abnormal tissue—in the lungs.

Lung cancer screening is one way to catch cancer early, when it is still a lung nodule. The other way, which is more common, of finding a lung nodule is incidental, while patients are getting lung imaging for other medical problems. Lung nodules that are suspicious or show signs of growth over time often need to be biopsied. Biopsy of lung nodule with bronchoscopy is preferred as risk of complications is very low and lymph node staging can be performed concurrently. However, traditional bronchoscopy has lower success for lung nodule biopsy. 

At the Yale Robotic Bronchoscopy Program, Yale interventional pulmonologists and thoracic surgeons will perform a next-generation bronchoscopy—robotic-assisted bronchoscopy with novel shape-sensing technology—that will allow them to visualize and biopsy remote parts of the lung that were previously inaccessible, significantly improving the success of lung nodule biopsy. 

Our Approach

The Yale Robotic Bronchoscopy Program takes a multidisciplinary approach to patient care; it is a joint program between Yale Interventional Pulmonology and Yale Thoracic Surgery, part of the Thoracic Oncology Program, which takes care of more than 40% of lung cancer patients in Connecticut while attracting patients from New England and beyond.

The goal of the program is to diagnose potentially cancerous lung nodules in the periphery and hard-to-read parts of the lungs. The robotic bronchoscopy technology will help to biopsy and diagnose those nodules with significantly improved accuracy and safety. Yale New Haven Hospital offers this new technology, which has greater dexterity, reach, vision, and shape-sensing technology that offers greater stability when compared with traditional bronchoscopy.

A regular bronchoscope has a camera on one end. The other end is held by a doctor who manually performs the procedure. With a robotic bronchoscopy, the endoscope is attached to a robotic arm, which the doctor operates from an independent console. 

The Yale doctors will be using robotic bronchoscopy concurrently with 3D fluoroscopy for real time imaging to further improve the accuracy of the procedure. Furthermore, doctors will also perform a procedure called EBUS—endobronchial ultrasound, which allows biopsy of the lymph nodes around the lungs and airways. This helps not just with the diagnosis but with the staging of lung cancer. Performing robotic-assisted bronchoscopy and EBUS under single anesthesia will help reduce the unnecessary waiting times and anxiety that patients may traditionally experience.