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Improve Precision and Efficiency in Diagnosing Lung Nodules with a Robotic Bronchoscopy in Naples, FL

Staying on top of your lung health is important, and if you’ve had a chest x-ray, CT scan or PET scan identify an abnormal growth, it should be thoroughly investigated as soon as possible. Lung nodules are often benign, however an early diagnosis of cancer can greatly improve your prognosis. At Meliora Healthcare, we offer a robotic-assisted bronchoscopy platform for minimally invasive peripheral lung nodule biopsies.

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What is robotic-assisted bronchoscopy (RAB)?

RAB is a newer more advanced bronchoscopy procedure performed in patients who have a lung nodule or a lung mass that needs a biopsy to find out if it is benign or cancerous. Our experienced team of pulmonologists use specialized software to digitally identify targets using images from a CT scan and then guide an ultra-thin and ultra-maneuverable bronchoscope (a flexible tube with a camera) to the target almost anywhere in the lungs with extreme precision using a hand controller. A variety of small, flexible tools can then be inserted through the bronchoscope.  Our physicians are able to image and biopsy lymph nodes and nodules using transbronchial needle aspiration (TBNA) or transbronchial forceps biopsy that would be otherwise difficult to reach with a traditional diagnostic bronchoscope.

Who Needs a RAB?

This procedure, similar to ENB, is typically performed to biopsy lung nodules so that your provider can determine the best course of action in your management moving forward. Most lung nodules are benign and thus not all lung nodules need to be biopsied. In fact, only 3 or 4 out of 100 lung nodules end up being cancerous. If you are at an increased risk for lung cancer or the nodule has a concerning appearance on a CT scan or PET scan, sampling of the nodule may be indicated. At Meliora Healthcare, our respected, award-winning and accomplished pulmonologists will evaluate and determine if this type of bronchoscopy is best suited for your condition.

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What Should I Expect?

Before your RAB procedure, you will likely need to take several steps in preparation. This can include undergoing a special type of CT scan called a Super-D or bronchoscopy protocol CT scan of the chest for mapping purposes. 

  • You will be told not to eat after midnight the night before (or about 8 hours before) the procedure. 
  • You will also receive instructions about taking your regular medicines, not smoking, and removing any dentures before the procedure. Be sure to ask about stopping any medications that thin the blood or prevent clotting. 
  • You will be under the care of an anesthesiology team that will monitor your heart rate, oxygen levels, blood pressure and breathing and will also manage the intravenous sedation that you will be receiving. You will be intubated (have a breathing tube in place) for the duration of the procedure.
  • You will be lying down on a procedure bed with the head of the bed tilted up slightly. The RAB scope is placed through the breathing tube, then advanced slowly into the airways and lungs where sampling is performed.

What happens after the procedure?

  • Patients vary in how long it takes to wake up from sedation. You will need to stay in a recovery area until the sedative has worn off, and you will also need to wait until any numbing medicine wears off before eating or drinking any liquids. 
  • You will need to have someone else drive you home after the procedure. 
  • It is unlikely that you will experience any problems after the test other than a mild sore throat, hoarseness, cough or muscle aches. You may also have a low grade fever for a day or two.
  • You may resume your regular activities after sedation wears off, however you should avoid strenuous activities on the day of the procedure.
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Robotic Bronchoscopy FAQ

Are there alternatives to a RAB?

How long does a RAB take?

How long will it take to get my results?

Is RAB safe?

Are there alternatives to a RAB?

Other tests such as X-rays, CT scans and PET scans can give some information about the lungs, but bronchoscopy allows the doctors to obtain very specific samples. Electromagnetic navigational bronchoscopy is an alternative procedure with similar risks and your pulmonologist will determine which type of bronchoscopy is best for you. CT guided needle biopsy by an interventional radiologist can provide similar diagnostic yields, however in most instances comes with a higher risk of complications. Surgical options including Video-Assisted Thorascopic Surgery (VATS) and thoracotomy are available but are much more invasive than RAB and require incisions and hospitalization afterwards.

How long does a RAB take?

The length of the procedure varies depending on what needs to be done and why you need it. Typically, it can last anywhere from 45 minutes to 90 minutes.

How long will it take to get my results?

Biopsies can take anywhere from 5-7 days and cultures can take anywhere from 72 hours to 6 weeks to finalize.

Is RAB safe?

RAB is a safe procedure. Serious risks from the procedure, such as an air leak or major bleeding, are uncommon and occur in less than 5% of patients. Your doctor will discuss the risks of the procedure with you in more detail at your visit.

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