Robotic lung biopsy, surgery provides higher accuracy, faster recovery for patients

This story first appeared in Healthy You - April 2025, The Gazette’s quarterly health publication.

Robotic surgery was first introduced in the late 20 th century and has long since found its place in the medical community. Yet despite its considerable use, robotic surgery is often misunderstood by patients.

Simply put, robotic surgery expands the surgeon's capabilities and offers an option to open surgery. The surgeon operates the surgical system by sitting at a console, where they manipulate tiny instruments through a 3D high-definition view of the surgical site, translating their hand movements into precise movements of the robotic arms inside the patient.

“Robotic systems are not automated by the machine. It’s an extension of the surgeon,” said Dr. Garry Weide, cardiothoracic surgeon at UnityPoint Health - St. Luke’s Heart and Lung Surgery in Cedar Rapids.

The Ion Endoluminal System — also known as the Ion robotic system — has been in clinical use for lung biopsies for about five years. The system helps doctors navigate deep into the lungs to obtain tissue samples for diagnosing lung cancer and other conditions. Its precision and minimally invasive approach has made it a valuable tool for detecting lung cancer earlier and more accurately than traditional bronchoscopy methods.

Its 3D imaging and planning provides detailed pre-procedure imaging and real-time navigation to improve accuracy. It uses an ultra-thin, flexible robotic catheter to reach small, hard-to-access lung nodules. And because the system enters the lungs via a bronchoscope, it reduces the need for more invasive biopsy techniques like surgery.

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“The Ion robot sees more and can biopsy areas that we couldn’t get to before. As a result, more patients are candidates for lung biopsies than ever before,” Weide said. “Previously, those who weren’t candidates had to ‘watch and wait’ to see how the affected area progressed.”

Surgery has also advanced due to the da Vinci Surgical System. Introduced over 20 years ago, it was initially used for minimally invasive procedures such as harvesting the mammary artery, performing coronary artery bypass grafts and repairing mitral valves. According to Intuitive Surgical, the company behind the da Vinci system, over 76,000 surgeons worldwide have been trained on da Vinci surgical systems and have completed more than 14 million surgical procedures using da Vinci systems.

Today, the fourth and latest generation of the da Vinci — the da Vinci Xi — is commonly used in lung cancer surgery, particularly when minimally invasive precision is required. “Over the last couple of years, St. Luke’s has been using the da Vinci Xi for thoracic surgery,” Weide said.

“The current generation instruments has 3D high-definition visualization and a far greater range of motion, allowing surgeons to manipulate and move the instruments in a lifelike orientation,” he added.

Its 3D high-definition (3DHD) camera provides a magnified view of the surgical site, enhancing depth perception and detail. The robotic arms are designed for greater dexterity, allowing for more precise movements during surgery. As a result, surgeons can now operate on hard-to-reach tumors, delicate structures or high-risk cases that previously required open surgery. Procedures include lobectomy, wedge resection and segmentectomy.

One of the notable features of the da Vinci Xi is the Firefly™ fluorescence imaging technology. Surgeons can visualize blood flow and tissue perfusion in real-time, which helps improve surgical outcomes by enabling better decision-making during operations.

How does the da Vinci Xi compare to traditional open surgery?

“Traditional open surgery requires a larger incision and a week in the hospital, followed by several weeks to a few months for recovery. With the da Vinci Xi, we make four small incisions, and the patient is typically in the hospital for two to three days,” Weide said.

The da Vinci Xi uses tiny incisions, reducing surgical trauma, pain and recovery time — allowing more patients to undergo the procedure safely. It also offers greater surgical precision, which means lower complication rates. Unlike previous models, the da Vinci Xi can reach multiple areas of the body without repositioning the system. This makes surgeries faster and more efficient.

“Overall, there’s less hospitalization, less bleeding and less pain, and the patient can resume normal activities within two to three weeks,” Weide said.

“I had a patient who had open surgery on his right lung years ago. Recently, I performed surgery on his left lung using the da Vinci Xi, and the patient remarked that his recovery was so much easier and better,” he added.

Whether it’s for lung biopsy or lung cancer surgery, robotic systems bring a great deal to the operating table and to lung cancer patients.