ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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76 Consecutive Cases of Robotic-Assisted Navigational Bronchoscopy at a Single Center
Session Title
TP137 - TP137 THORACIC ONCOLOGY: DIAGNOSIS AND TREATMENT: IP, SURGERY, AND RADIATION
Abstract
A4820 - 76 Consecutive Cases of Robotic-Assisted Navigational Bronchoscopy at a Single Center
Author Block: A. Bajwa1, S. Bawek2, S. Bajwa3, A. Rathore4; 1Pulmonary/Critical Care and Sleep Medicine, Jacksonville, FL, United States, 2Lake Eerie College of Osteopathic Medicine, Bradenton, FL, United States, 3Ponte Vedra High School, Ponte Vedra Beach, FL, United States, 4Lake Erie College of Osteopathic Medicine, Eerie, PA, United States.
RATIONALE: The diagnostic yield of electromagnetic navigational bronchoscopy to access lung lesions remains low. The multicenter NAVIGATE study showed the diagnostic yield to be 71% for lesions up to 3 cm and 67% for lesions up to 2 cm. The recent introduction of robotic assisted navigational platforms may overcome some of the traditional barriers encountered with previous platforms. We aim to assess the diagnostic yield and safety of the Ion™ endoluminal system (Intuitive Surgical, Inc., Sunnyvale, California) in the first 76 consecutive cases at our institute.
METHODS: We retrospectively reviewed and analyzed data of the first 76 consecutive robotic-assisted navigational bronchoscopy cases. All patients underwent the procedure at a single community tertiary care center from March 11, 2020 to November 25, 2020.
RESULTS: Seventy-six patients were included in the analysis. The mean age was 68.4 years (± 11.1), mean BMI was 27.8 (± 6.1) and 54% were women. The median size of the lesion was 1.7 (range, 0.6 - 7) cm. Majority of the lesions were in the upper lobes (62%) and 34% of all lesions were in the left upper lobe. No complications were encountered. The median duration of the procedure, from patient arriving in the room to leaving the room was 58 (range, 23-102) min. Radial endobronchial ultrasound (REBUS) view of the lesion was concentric in 46% (n=35), eccentric in 30% (n=23) cases and no signal of lesion was seen in 24% (n=18). There was no correlation between acquisition or type of a REBUS signal to diagnostic yield. The overall diagnostic yield was 92% (n=72). Malignancy accounted for 59% (n=45) cases, inflammatory lesion 29% (n=22) benign non inflammatory lesion 4% (n=3) and 8% (n=6) were non diagnostic. Inflammatory lesion diagnosis included infectious (abscess, Cryptococcus, Aspergillus) non infectious (organizing pneumonia, granulomas). 91% (n=20) of the inflammatory lesions showed resolution or improvement on follow up and 2 are pending follow up.
CONCLUSIONS: Robotic navigational bronchoscopy using the Ion™ endoluminal system shows excellent diagnostic accuracy with a very low complication rate.
Author Block: A. Bajwa1, S. Bawek2, S. Bajwa3, A. Rathore4; 1Pulmonary/Critical Care and Sleep Medicine, Jacksonville, FL, United States, 2Lake Eerie College of Osteopathic Medicine, Bradenton, FL, United States, 3Ponte Vedra High School, Ponte Vedra Beach, FL, United States, 4Lake Erie College of Osteopathic Medicine, Eerie, PA, United States.
RATIONALE: The diagnostic yield of electromagnetic navigational bronchoscopy to access lung lesions remains low. The multicenter NAVIGATE study showed the diagnostic yield to be 71% for lesions up to 3 cm and 67% for lesions up to 2 cm. The recent introduction of robotic assisted navigational platforms may overcome some of the traditional barriers encountered with previous platforms. We aim to assess the diagnostic yield and safety of the Ion™ endoluminal system (Intuitive Surgical, Inc., Sunnyvale, California) in the first 76 consecutive cases at our institute.
METHODS: We retrospectively reviewed and analyzed data of the first 76 consecutive robotic-assisted navigational bronchoscopy cases. All patients underwent the procedure at a single community tertiary care center from March 11, 2020 to November 25, 2020.
RESULTS: Seventy-six patients were included in the analysis. The mean age was 68.4 years (± 11.1), mean BMI was 27.8 (± 6.1) and 54% were women. The median size of the lesion was 1.7 (range, 0.6 - 7) cm. Majority of the lesions were in the upper lobes (62%) and 34% of all lesions were in the left upper lobe. No complications were encountered. The median duration of the procedure, from patient arriving in the room to leaving the room was 58 (range, 23-102) min. Radial endobronchial ultrasound (REBUS) view of the lesion was concentric in 46% (n=35), eccentric in 30% (n=23) cases and no signal of lesion was seen in 24% (n=18). There was no correlation between acquisition or type of a REBUS signal to diagnostic yield. The overall diagnostic yield was 92% (n=72). Malignancy accounted for 59% (n=45) cases, inflammatory lesion 29% (n=22) benign non inflammatory lesion 4% (n=3) and 8% (n=6) were non diagnostic. Inflammatory lesion diagnosis included infectious (abscess, Cryptococcus, Aspergillus) non infectious (organizing pneumonia, granulomas). 91% (n=20) of the inflammatory lesions showed resolution or improvement on follow up and 2 are pending follow up.
CONCLUSIONS: Robotic navigational bronchoscopy using the Ion™ endoluminal system shows excellent diagnostic accuracy with a very low complication rate.
