VA Medical Center Uses New Robotic Arm to Diagnose Lung Cancer in Veterans

The Monarch Robotic-assisted Bronchoscopy Platform uses advanced technology to help physicians reach further into the lungs to examine and biopsy nodules that may be cancerous. The VA hopes the new technology will reduce the number of Veterans losing the battle to lung cancer each year.  

“Only 18 percent of newly diagnosed lung cancer patients will survive five years or more,” said Washington DC VA Medical Center’s Chief of Cardiothoracic Surgery, Gregory Trachiotis, MD. “The key to survival is early detection, when lung cancers are much more easily treated, as over 50% of currently new diagnosed lung cancer present in advanced stages.”

Historically, screening and testing nodules in less accessible areas of the lungs has been difficult. Using a procedure called a bronchoscopy, physicians manually ran a tube with a small camera inside, down a patient’s throat and into the lungs. From there, they maneuvered the camera or instruments to see and biopsy suspicious nodules.

With the VA’s new Monarch Platform, physicians use a controller to move a flexible bronchoscopy tube an average of 4.2 cm further than ever before. The precision and steadiness of the robotic assistance allows them to examine all 18 chambers of the lungs to identify and biopsy areas of concerns.

With the integrated camera, and an irrigation and suction system, the controller can see exactly where they are going and what they are doing in real-time. Once they have reached a nodule they wish to biopsy, the physician can “park” the bronchoscope in place to reduce unwanted movement and switch their attention to other instruments. Through the remote controller, they can manipulate each component of the Monarch’s bronchoscope individually, allowing for a more precise and less invasive exploration of the entire lung.

Rahul Khosla, MD, Chief of Pulmonary Medicine at the DC VA Medical Center, coordinates the lung screening and lung nodule program and pulmonary team. He is optimistic about the platform’s ability to biopsy “smaller and harder-to-reach” areas of the lung. Trachiotis and Khosla have already used the new technology to accurately diagnose and create treatment plans for 5 Veterans, where 4 were diagnosed with early lung cancer.

“This provides us a highly accurate way of identifying Veterans in our lung cancer screening program that may need early intervention,” said Trachiotis. “We can identify new pulmonary lesions that may be premalignant or very early stages of new lung cancer, diagnose at an earlier, more treatable stage and improve overall survivability and longevity.”

More than eight thousand Veterans are diagnosed with lung cancer annually. Previously, nearly five thousand of those Veterans would lose that battle. Trachiotis is hopeful that though a collaborative effort of health care professionals and the VA’s investment in cutting edge technology, the number of lung cancer survivors will grow.  He added, “At the DC VA Medical Center, our multidisciplinary care team of thoracic surgeons, pulmonologists, oncologists, radiologists, and cancer coordinators work together to find lung cancer earlier, develop a treatment plan and save lives. We are grateful to be able to offer this to our Veterans.”