Interventional Pulmonology team performing a cone-beam CT-guidedbronchoscopic lung biopsy with Dwayne Free, senior respiratory therapist (left) and Harmeet Bedi, MD (center).
Doctor Stories
Innovations in Interventional Pulmonology: Harnessing Robotic Bronchoscopy for Diagnosing and Treating Lung Cancer
03.04.2024
As a top center in the U.S. for pulmonology and lung surgery, Stanford Health Care is helping define modern lung cancer care. Novel interventional pulmonology approaches pioneered by Stanford Medicine physicians are making lung cancer diagnosis and treatment safer and more effective.
“Robotic bronchoscopy offers a novel approach to biopsy and the diagnosis of lung cancers,” says Harmeet Bedi, MD, director of interventional pulmonology and bronchoscopy at Stanford University School of Medicine. “It’s exciting to be at the leading edge of medicine and improving how we biopsy lung nodules. We’re also thrilled to announce the expansion of our services with two local hospitals in the San Francisco Bay Area. This expansion will bring robotic bronchoscopy to more patients, giving them easier access to this important technology.”
Robotic Bronchoscopy With Cone Beam CT Guidance for Lung Nodule Biopsies
The standard approach to lung nodule biopsies is to use a flexible bronchoscope or a percutaneous needle with CT guidance. Both techniques have limitations. A traditional, flexible bronchoscope lacks accuracy. With a needle biopsy, the diagnostic success rate is higher, but there is a higher risk of lung collapse with this method.
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Our Interventional Pulmonology Program in Palo Alto offers advanced, minimally invasive diagnosis and treatment options for thoracic abnormalities and pulmonary disease.
650-725-7061
Harmeet Bedi, MD
Dr. Bedi and his colleagues saw the potential to overcome these limitations using their new robotic bronchoscopy technology. “We integrated the robotic bronchoscope with a cone beam CT (CBCT) scanner,” says Dr. Bedi. “The robotic technology improves our precision when we are navigating towards a lung nodule (or potential cancer), and the CBCT scanner gives the final confirmation on whether our biopsy tool is in the lung nodule.”
Once Dr. Bedi reaches the lung nodule, he uses another novel technique to collect the tissue — cryobiopsy. Initially developed to diagnose interstitial lung disease, cryobiopsy involves freezing the lung tissue before removal. The benefit of cryobiopsy is that it allows the physician to take out a larger tissue sample using a minimally invasive procedure. Dr. Bedi’s team was one of the earliest adopters of cryobiopsy for lung nodules and tumors.
The use of robotic CBCT bronchoscopy at Stanford Health Care has grown dramatically — from about 44 cases per year in 2019 to 400 in 2023. “It’s now the most common method we use for lung nodule biopsies at Stanford Healthcare” says Dr. Bedi.
Lung Cancer Ablation with Robotic Bronchoscopy
Stanford Health Care is part of a clinical trial (ClinicalTrials.gov Identifier: NCT05299606) to use robotic bronchoscopy with microwave ablation therapy to treat metastatic lung tumors.
“In 2023, we performed our first robotic ablation procedure, which was also the first in the U.S.,” says Dr. Bedi. “Using our CBCT scanner, we confirmed how much heat we applied to different portions of the tumor. Follow-up imaging in that patient showed an excellent response to the microwave treatment.”
The clinical trial is ongoing at 10 sites. Other trials are on the horizon to look at ablation with robotic bronchoscopy for different types of cancers within the lungs. Dr. Bedi plans to participate in as many new trials as possible. Eventually, he expects this state-of-the-art therapy to become the standard of care option for certain types of lung cancer and metastatic tumors (to the lungs).
Referring Patients for Lung Nodule Biopsies
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff.
To refer a patient to the Stanford Health Care Chest Clinic for interventional pulmonology:
- Call: 1-866-742-4811
- Email: referralcenter@stanfordhealthcare.org
- Fax: 650-320-9443
- Submit a web referral
For more information about interventional pulmonology at Stanford Health Care contact:
Harmeet Bedi, MD
Director of Interventional Pulmonology & Bronchoscopy, Stanford University School of Medicine
Clinical Associate Professor, Medicine-Pulmonary, Allergy & Critical Care Medicine
hbedi@stanford.edu
650-736-0125
About Stanford Health Care
Stanford Health Care seeks to heal humanity through science and compassion, one patient at a time, through its commitment to care, educate and discover. Stanford Health Care delivers clinical innovation across its inpatient services, specialty health centers, physician offices, virtual care offerings and health plan programs.
Stanford Health Care is part of Stanford Medicine, a leading academic health system that includes the Stanford University School of Medicine, Stanford Health Care, and Stanford Children’s Health, with Lucile Packard Children's Hospital. Stanford Medicine is renowned for breakthroughs in treating cancer, heart disease, brain disorders and surgical and medical conditions. For more information, visit: www.stanfordhealthcare.org.