Ion Robotic Bronchoscopy
NCH pulmonologists use the Ion robotic-assisted bronchoscopy system to reach small, hard-to-access lung nodules and collect a tissue sample for diagnosis — a minimally invasive alternative to more invasive biopsy approaches.
What Is Ion Robotic Bronchoscopy?
Ion robotic bronchoscopy is a minimally invasive procedure that uses the Ion endoluminal system, developed by Intuitive, to help physicians biopsy lung nodules that may be difficult to reach with a standard bronchoscope. Before the procedure, your care team uses a CT scan of your chest to build a detailed 3D map of your airways and a planned pathway to the nodule.
During the procedure, your physician guides an ultra-thin, fully articulating robotic catheter through the mouth and airways — with no incisions or punctures through the chest wall — using this 3D map along with real-time imaging. Once the catheter reaches the target area, biopsy tools are passed through the catheter to collect a tissue sample, which is sent to a lab for evaluation.
Because more than 70% of lung nodules are located in the outer third of the lung, in areas with tight spaces and narrow airways, robotic-assisted platforms like Ion are designed to help physicians access and sample nodules that may be harder to reach with traditional bronchoscopy.
Why Might I Need Ion Robotic Bronchoscopy?
Your pulmonologist may recommend Ion robotic bronchoscopy when imaging has identified a lung nodule or mass that needs a tissue sample to help determine a diagnosis.
Common Reasons for Referral
Nodule Found on CT Scan
Including nodules identified during lung cancer screening
Peripheral or Hard-to-Reach Nodule
Located in the outer portion of the lung
Nodule Requiring Tissue Diagnosis
To help determine if further treatment is needed
Small Nodule Size
Need for Lymph Node Evaluation
Preference to Avoid Chest Wall Puncture
Multiple Nodules
Findings on Prior Imaging or Exam
Not every lung nodule requires biopsy — your physician will review your imaging, medical history, and individual risk factors to determine whether Ion robotic bronchoscopy, another biopsy approach, continued monitoring with imaging, or a different next step is most appropriate for you.
What It Can Help Diagnose
Ion robotic bronchoscopy is used to obtain a tissue sample that can help identify or rule out:
- Lung cancer
- Benign (non-cancerous) nodules
- Infectious causes of a nodule
- Inflammatory lung conditions
- Metastatic disease involving the lung
A biopsy result showing cancer does not determine treatment on its own — your care team will use the pathology findings, along with staging and other test results, to help guide next steps. Your pulmonologist will discuss what your specific results mean for you.
Your Procedure Journey
From evaluation through recovery, here’s what to expect at each stage
Consultation
Review of prior imaging; a dedicated planning CT scan maps the nodule and pathway
Preparation
Fasting and medication instructions ahead of general anesthesia
Day of Procedure
Robotic catheter navigates the 3D-mapped airway route; tissue sample is collected
Recovery
Monitored recovery as anesthesia wears off; chest X-ray often performed before discharge
Results & Follow-Up
Pathology results reviewed with your care team; next steps discussed
Seek care promptly if you develop chest pain, shortness of breath, coughing up significant amounts of blood, or fever after the procedure. Download the full Prep Guide →
Is Ion Robotic Bronchoscopy Right for You?
Weighing Ion robotic bronchoscopy against other biopsy approaches, and understanding the risks, are both part of deciding whether it’s the right path for evaluating your lung nodule.
| Ion Robotic Bronchoscopy | Traditional Bronchoscopy | CT-Guided Needle Biopsy | |
|---|---|---|---|
| Best for | Small, peripheral nodules in hard-to-reach areas | Central airway abnormalities or larger, more accessible lesions | Nodules located near the outer edge of the lung, close to the chest wall |
| Method | Robotic catheter guided by a 3D CT-based map, through the airways | Manually guided flexible scope, through the airways | Needle advanced through the chest wall under CT guidance |
| Setting | Hospital procedure suite, general anesthesia | Bronchoscopy suite, typically with sedation | Outpatient imaging suite, local anesthesia with or without sedation |
| Pneumothorax risk | Reported in the low single digits in published studies | Generally low for central airway procedures | Higher than airway-based approaches, since the needle passes through lung tissue |
Risks & Safety
As with any bronchoscopic procedure performed under general anesthesia, Ion robotic bronchoscopy carries risks. Your physician will review your individual risk factors before the procedure.
Pneumothorax
A collapsed lung is a possible complication of any bronchoscopy; some cases require a temporary chest tube.
Bleeding
Some bleeding at the biopsy site is common and is typically managed during the procedure.
Anesthesia-Related Risks
General anesthesia carries its own risks, which vary based on your health history; your anesthesia team will discuss these with you.
Rare Serious Complications
Infection, respiratory or cardiac complications, and other rare but serious events are possible, as with any bronchoscopic procedure.
Important safety information: Bronchoscopic procedures under general anesthesia carry risks including bleeding, pneumothorax, respiratory or cardiac complications, and, rarely, death. Talk with your physician about the risks and benefits for your specific situation.
Results & Next Steps
The tissue sample collected during your procedure is sent to a pathology lab for evaluation. Your care team will let you know when to expect your results and will review the findings with you, along with what they mean for your specific situation.
If the biopsy identifies a benign (non-cancerous) finding, your physician may recommend a period of monitoring with follow-up imaging. If the results raise further questions, additional testing may be needed.
If cancer is identified, your care team will use the biopsy results together with staging information and other tests to help guide a personalized treatment plan, which may involve referral to oncology, thoracic surgery, or radiation oncology.
- Continued monitoring with follow-up imaging
- Additional or repeat biopsy
- Referral to pulmonary oncology
- Referral to thoracic surgery
- Staging with EBUS or additional imaging
- Treatment planning with radiation oncology
- Discussion of a broader lung cancer screening plan
Frequently Asked Questions
What is Ion robotic bronchoscopy?
Ion robotic bronchoscopy is a minimally invasive procedure that uses a robotic, catheter-based system to navigate the airways and biopsy lung nodules, including nodules in hard-to-reach areas of the lung, without an incision through the chest wall.
Will I be awake during the procedure?
No. Ion robotic bronchoscopy is performed under general anesthesia, so you will be asleep for the procedure. Your anesthesia team will monitor you closely throughout.
Is Ion robotic bronchoscopy painful?
You will not feel the procedure itself, since you are under general anesthesia. Afterward, some patients experience a sore throat, mild hoarseness, or throat discomfort for a day or two, which is common after any bronchoscopy.
How long does the procedure take?
The procedure itself typically takes about 1 to 2 hours. Plan to be at the facility for 4 to 6 hours total, which includes registration, anesthesia preparation, the procedure, and recovery monitoring.
What are the risks of robotic bronchoscopy?
As with any bronchoscopic procedure under general anesthesia, possible risks include bleeding, a collapsed lung (pneumothorax), infection, and anesthesia-related complications. Serious complications are uncommon. Your physician will review your specific risk factors before the procedure.
How long until I get my biopsy results?
Turnaround time can vary depending on the type of testing needed on your tissue sample. Your care team will let you know when to expect your results and will schedule a follow-up visit to discuss them with you.
Will I need someone to drive me home?
Yes. Because the procedure requires general anesthesia, you will need a friend or family member to drive you home and should avoid driving for 24 hours afterward.
How is Ion different from traditional bronchoscopy?
Traditional bronchoscopy is guided manually and is generally better suited to larger, more central airway findings. Ion uses a robotic, shape-sensing catheter and a 3D map built from your CT scan to help physicians reach smaller nodules in the outer regions of the lung that can be harder to access with a standard bronchoscope.
Location
Consultations are available at NCH Pulmonary outpatient offices; the robotic bronchoscopy procedure itself is performed at an NCH hospital procedure suite under general anesthesia.
311 9th Street North, Suite 304, Naples, FL 34102
(239) 624-8250Explore All Pulmonary Services
Conditions, screenings, and advanced lung care at NCH.
Schedule a Pulmonary Consultation
Talk with an NCH pulmonologist about whether Ion robotic bronchoscopy is right for you.