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Published on: July 19, 2024
Ion Robotic Bronchoscopy-Guided Microwave Ablation Under Augmented Fluoroscopy: An Initial Case Series and
Yuan Xu1, Chao Guo1, Yingzhi Qin1
1Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1# Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Cardiovascular and Interventional Radiology
|August 13, 2026
Summary
Robotic-assisted bronchoscopy (RAB) with microwave ablation (MWA) offers a safe and effective treatment for peripheral pulmonary lesions. This advanced technique significantly reduces procedure times and patient radiation exposure compared to traditional methods.
Area of Science:
- Pulmonary Medicine
- Interventional Pulmonology
- Medical Robotics
Background:
- Bronchoscopic microwave ablation (MWA) is an emerging treatment for peripheral pulmonary lesions.
- Clinical data on the Ion robotic-assisted bronchoscopy (RAB) system for MWA is limited.
- Augmented fluoroscopy (AF) is a workflow strategy used in bronchoscopic procedures.
Purpose of the Study:
- To evaluate the initial prospective experience of Ion RAB-guided MWA.
- To benchmark the outcomes of Ion RAB-guided MWA against a historical cohort using electromagnetic navigation bronchoscopy (ENB).
- To assess the feasibility, safety, and efficiency of the Ion RAB-guided MWA workflow.
Main Methods:
- Prospective single-center cohort study of 21 patients undergoing Ion RAB-guided MWA for 25 pulmonary lesions.
- Comparison with a historical cohort of 42 patients undergoing ENB-guided MWA for 51 lesions, both using an AF strategy.
- Primary endpoint: Postoperative day 1 (POD1) technical success. Secondary endpoints: 6-month treatment success, workflow times, cone-beam CT (CBCT) acquisitions, radiation dose, and complications.
Main Results:
- 100% technical success for RAB vs. 92.9% for ENB (p=0.545) on POD1.
- 100% treatment success for RAB vs. 90.5% for ENB (p=0.292) at 6 months.
- RAB significantly reduced navigation time (2 vs. 28.5 min), total workflow time (75 vs. 128 min), CBCT acquisitions (2 vs. 4), and radiation dose (118 vs. 215 mGy) compared to ENB (all p<0.001).
Conclusions:
- Ion RAB-guided MWA under an augmented fluoroscopy workflow is feasible and safe for peripheral pulmonary lesions.
- The RAB system provides precise ablation capabilities.
- This robotic-assisted approach offers superior efficiency and significantly lowers patient radiation exposure.
Keywords:
Augmented fluoroscopyElectromagnetic navigation bronchoscopy (ENB)Lung cancerMicrowave ablation (MWA)Peripheral pulmonary lesionsRobotic-assisted bronchoscopy (RAB)