February 26, 2024

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CU Medicine Performs First Robotic Bronchoscopy Microwave Ablation for Lung Metastases

Image Credits: CUHK, Press Release

Malignant cancers originating from different organs frequently metastasize to the lungs. Traditional surgical removal of lung metastases can result in significant surgical trauma and the unwanted removal of adjacent healthy lung tissue. The Faculty of Medicine at the Chinese University of Hong Kong (CU Medicine) has carried out the world’s first bronchoscopic microwave ablation of lung metastases, assisted by robotics.

Since October 2022, they have successfully treated three patients with a total of six lung metastases using this innovative technique. This procedure allows doctors to accurately access peripheral areas of the lung and perform non-invasive, lung-sparing microwave ablation of lung metastases. It is currently in clinical trials, with a goal of enrolling up to 145 patients worldwide.

Robotic bronchoscopic microwave ablation protects lung function and avoids surgery trauma

Patients with lung metastases may have undergone prior surgery or be receiving chemotherapy for their advanced-stage cancer. They may already be physically and mentally weakened from the various treatments they are receiving. The primary treatment for lung metastases is surgical resection, but this can lead to trauma during access and the removal of healthy lung tissue.

For precise delivery of a small catheter into the small airways to reach lung metastases and perform non-invasive transbronchial microwave ablation, an advanced navigation bronchoscopy platform is required. This novel form of treatment is unique as it does not require surgical wounds, resulting in minimal pain and blood loss. Moreover, it is lung parenchymal sparing, meaning it does not involve the removal of healthy lung tissue. Microwave energy is used during the procedure to heat and destroy cancer cells.

CU Medicine has been at the forefront of using bronchoscopy with navigational capabilities to diagnose and treat peripheral lung tumours. With the latest robotic-assisted bronchoscopy platform, there are added advantages over previous systems, including improved navigation accuracy to lung lesions and greater procedural stability. This innovative approach of using robotic bronchoscopy for transbronchial microwave ablation of lung metastases can be a significant change for those with advanced-stage metastatic lung cancer.

According to Dr Rainbow Lau Wing-hung, a Clinical Assistant Professor (honorary) in the Division of Cardiothoracic Surgery, Department of Surgery at CU Medicine, bronchoscopy is an endoscopic procedure commonly carried out by doctors specializing in lung disorders.

The new robotic-assisted bronchoscopy employs real-time optical imaging and electromagnetic positioning to navigate the complex human airways. The operator can use a remote console to accurately drive the device to the desired location within the lung, which is linked with the robotic arms and bronchoscope. The advanced robotic mechanism within the bronchoscope ensures stability while deploying the microwave ablation catheter, improving the accuracy and efficiency of the ablation procedure.

CU Medicine: pioneering thoracic surgical treatments in the Asia-Pacific region

CU Medicine’s thoracic surgical team has been at the forefront of using advanced minimally invasive techniques with the latest technologies. These include single port video-assisted thoracoscopic surgery for major lung resection, as well as image-guided surgery and navigation bronchoscopy in the Hybrid Operating Room.

Professor Calvin Ng Sze-hang, a Professor in the Division of Cardiothoracic Surgery, Department of Surgery at CU Medicine, expressed his excitement about performing the world’s first robotic-assisted bronchoscopy microwave ablation of lung metastases.

By combining the advantages of precise airway navigation with robotic bronchoscopy and CU Medicine’s world-leading experience in transbronchial microwave ablation of lung tumours, patients with lung metastases now have an additional non-invasive treatment option.

Patients with advanced cancer often have multiple lung metastases spread throughout both lungs. Conventional surgical resection involves bilateral surgical incisions and the removal of multiple lung tissue wedges, which can have a significant impact on the patient’s lung function and may delay chemotherapy administration as they recover from surgery.

The novel approach of using robotic bronchoscopic microwave ablation allows for the treatment of multiple bilateral lung metastases without any incisions or lung resection. This method has almost no impact on the patient’s lung function or quality of life.

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