Combined robotic
assisted thoracic surgery is exactly what the name says.
We're going to combine the two latest technology
robots together in one surgical procedure.
We're going to use the ION robot bronchoscope
to help reach the small target which we're concerned may be a cancer
so we can more accurately biopsy it.
We're going to put some dye marking around that target to help the surgeon
be able to see it later.
And we're going to use
endobronchial ultrasound to sample lymph nodes on both sides of the chest
so that we can make sure there's no lymph node involvement.
If there's no lymph node involvement and we've proven cancer,
then we're going to switch over to have the surgeon do
the thoracic surgery using the DaVinci robot to remove the tumor.
The combined
procedure means that we are able to do
the two parts of the procedure at the same time.
So, we're using the benefits of the two cutting-edge technologies,
the ION robotic bronchoscope and the DaVinci surgical robot
at the same time on the same day.
So, the patients don't have to come in on separate occasions.
The benefit is that we can sample
the lesion we can sample the lymph nodes, and provided
there are no surprises, we can then go on to do a formal surgical procedure.
This new procedure means that patients have a shorter
time from the time they get the CAT scan and are told they have a lung nodule
until they have a diagnosis, staging and treatment.
We're moving the ball from several weeks
between the time of the CAT scan to the time of the surgery
to trying to bring that down to as little as 5 hours.
This combined approach is better than in the past
in that we are able to get the patient diagnosed
and treated in a far more
rapid fashion. The patients are seen quicker
by both the interventional pulmonologist and surgeons,
and they go on to a definitive treatment in a shorter
period of time.
Patients
that are at risk for developing lung cancer are mostly smokers.
Patients who smoke 20 pack years or more of cigarettes.
Patients who have smoked within the past 15 years or are currently smoking
and age 50 to age 80 are patients
who are candidates for lung cancer screening.
So, what we need to do is get more patients to complete the lung cancer
screening, CT scan, and if you're found to have a lung nodule,
then you might be a candidate for doing this combined robotic assisted
thoracic surgery procedure.
I think it's important to realize that
while we're doing the procedure together, at the same time, we are both seeing
the patients separately and assessing their suitability for the procedure.
So, the primary folks will see the patient, see whether they can perform
the bronchoscopy,
and I will see them and decide whether we can do the surgery.
And we're both deciding whether they are suitable candidates to have surgery, both
from an oncological point of view as well as from a physiological point of view.
The ideal patient for combined robotic assisted
thoracic surgery is a patient who has a small lung nodule
and has no obviously enlarged lymph nodes in the middle of the chest.
This is somebody who could potentially be cured with surgery alone.
And as long as we do not think they have any involvement in lymph nodes,
they would be the perfect patient to see us.
So, the goal is to be operating on these patients
as quickly as possible, as soon as the lesion is detected.
If we can prevent having to schedule with one set of physicians
and then schedule with the surgeons,
if we can get it all done at one point in time
and we can shorten the period of time between the the lesion
being detected and going on to hopefully what could be a curative
treatment.
It's very important to be able to diagnose lung cancer
when it's in a smaller size, when it doesn't cause
symptoms, when it hasn't spread to other parts of the body.
Having a robot bronchoscope allows us to reach
these small tumors before, hopefully, they have spread to other places.
It has a combination of a high resolution
CT scan that allows us to create a plan
and we use our virtual created pathways to reach the target.
Sometimes this target may be all the way out in the periphery of the lung in places
that are hard to reach with traditional bronchoscopes.
This allows us to reach the target, stay stable so that we can biopsy it,
get a diagnosis of what's going on, and to put dye around the target
so that when the surgeon is doing the robotic resection
of this tumor, they should be able to see it more accurately.
This is especially helpful for smaller tumors that may not be as solid.
The ION robot has
only been out since 2020. It is a new technology.
It allows for a more accurate approach to get to small targets.
We've been able to reach targets that are as small as less than one
centimeter, seven, eight or nine millimeters.
So, that technology being more accurate to reach the actual small lung nodule
has allowed us to diagnose smaller lung tumors.
Millimeters matter when it comes to lung cancer.
If we can diagnose cancers when they're less than one centimeter,
patients have the best chance for overall survival.
The goal should always be to try to get the diagnosis as soon as possible
and on the smallest target as possible. We now have technology
to make that happen.
Using the robot,
we're able to perform very accurate,
minimally invasive surgery to treat their lung cancers.
So, I think we need to realize the benefit of the minimally invasive DaVinci robot.
That's where the benefit of the surgery lies.
We no longer have to do big incisions.
There are multiple benefits of minimally invasive surgery,
including less pain, quicker recoveries, less blood loss,
potentially even a better prognosis with respect
to their early stage lung cancers.
Previously,
we would see the patient separately in two teams and two different procedures,
one for diagnosing and staging the target
and one for actually removing the tumor.
This combined approach allows us to do this as a single procedure
in the operation.
During one operation, the patient's going to get a diagnosis,
have their lymph nodes removed and sampled, and have dye
marking put in to help localize the smaller targets,
and then have their treatment for their cancer.
So, we're talking about diagnosis, staging, and definitive treatment,
all in one procedure.