Ion: Technology and Techniques for Shape-sensing Robotic-assisted Bronchoscopy

Abstract Purpose The authors describe the Ion Endoluminal System and practices for safe and effective use in patients with small peripheral pulmonary nodules (PPNs). Description The shape-sensing robotic-assisted bronchoscopy system allows airway visualization and navigation to reach and biopsy small PPNs through a stable platform. The system provides three-dimensional mapping and visualization of the airways, a flexible, fully articulating 3.5-mm (outer diameter) catheter, peripheral vision probe, and system-specific biopsy needles. Evaluation The system was evaluated in an ongoing prospective, multicenter trial including 241 patients with 270 PPNs (largest mean cardinal measurement: 18.84±6.5 mm). Mean time to register and navigate decreased from 10 minutes in the first 10 cases to 7 minutes in the subsequent cases. Asymptomatic pneumothorax occurred in 8 subjects (3.3%), one (0.4%) with pigtail catheter placement. Two subjects (0.8%) experienced airway bleeding; both resolved within 5 minutes of tamponade. Conclusions The Ion Endoluminal System’s unique shape-sensing technology can be leveraged to facilitate localization and sampling of PPNs and potentially improve diagnostic accuracy.