First in the world! Sir Run Run Shaw Hospital Introduces a "One-Stop" Technique to Tackle Bilateral Lung Nodules

"This is a further step toward 'one-stop precision strike'—synchronously targeting both lungs, which is a world-first," explained Dr. Zhang Jisong, Consultant at Sir Run Run Shaw Hospital (SRRSH), Affiliated with Zhejiang University School of Medicine. "We have compressed what previously required multiple procedures into a single operation, significantly reducing the physical and psychological burden on patients."

The patient, Mr. He, 65-year-old, had a complex medical history. Years ago, he underwent two surgeries to remove malignant lung nodules, followed by radiotherapy and chemotherapy. During a follow-up examination, two high-risk ground-glass nodules were found, one in each lung, both continuously enlarging. Given his poor physical condition, another surgery seemed unbearable. In April of this year, Mr. He and his family came to SRRSH. Considering the patient’s overall health and the rapid growth of both nodules, Dr. Chen Enguo’s team decided to adopt the Ion robotic bronchoscopy system to perform cryobiopsy and ablation on the bilateral lung nodules simultaneously.

"We have successfully performed the first Ion robotic bronchoscopy-guided lung nodule biopsy in Zhejiang Province and have accumulated experience from dozens of such procedures. This time, we took a further step—a 'one-stop precision strike' that is the first of its kind in the world: synchronous bilateral lung nodule cryobiopsy and ablation," Dr. Zhang noted. "This essentially integrates what used to require multiple surgeries into a single procedure, greatly alleviating the patient’s physical and mental burden."

During the procedure, the team first used the patient’s preoperative CT data to create a detailed 3D “digital map” of the lungs. An artificial intelligence algorithm then automatically planned the optimal surgical path. Under the precise control of the robotic system, a flexible catheter with a diameter of only 3.5 millimeters navigated through the natural airways of the bronchi, traversing eight generations of bronchial branches, and simultaneously reached the target nodules deep in both lungs. The entire process, including biopsy and ablation, was completed in just 2.5 hours.

A postoperative CT scan within 24 hours confirmed successful ablation with full coverage of the targets and no complications. The patient was discharged the next day.

                                                     Pre-operation         24 hrs after the operation   1 month after the operation

"The Ion shape-sensing robotic bronchoscopy system is hailed as a 'GPS within the bronchi'," Dr. Zhang explained. One of the biggest challenges in conventional bronchoscopy is maintaining precise instrument positioning during patient respiration. The Ion robot’s unique shape-sensing technology solves this problem—it updates the location in real time at a frequency of 2,000 times per second, keeping the margin of error within 1 millimeter even during patients’ breathing.

Moreover, the Ion robot’s unique flexible catheter design triples the coverage range of conventional instruments, allowing access to the most peripheral areas of the lungs without neglecting operational blind spots. This is particularly advantageous for nodules smaller than 2 centimeters and ground-glass nodules, which are difficult to sample using conventional biopsy methods. “As the first medical institution in Zhejiang Province to adopt Ion robotic technology, we have achieved a diagnostic accuracy rate of over 90% for lung nodules smaller than 2 centimeters, with a record of no post-surgery pneumothorax and bleeding,” Dr. Zhang said.

"Since introducing the first Ion shape-sensing robotic bronchoscopy system in Zhejiang Province, we have continuously pushed the boundaries of technology. To date, we have successfully completed over 130 robot-assisted bronchoscopy procedures," said Dr. Chen Enguo, Senior Consultant and Director of the Department, “Most patients can resume daily activities within 24 hours after the procedure.”