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Robot-assisted bronchoscopy: diagnosing, staging lung cancer early

Lung cancer is the deadliest cancer there is, killing more people every year than breast, colon and prostate cancers combined. One of the main barriers to improving survival is timely diagnosis. Patients with early stage lung cancer often have no symptoms, which delays the diagnosis until the cancer is more advanced and difficult to treat.

Robotic-assisted bronchoscopy is a new technology that facilitates diagnosis of early stage lung cancer, resulting in improved survival. Jonathan Hovda, MD, a pulmonologist with Minnesota Lung Center, is one of the pioneers in utilization of this new technology. He practices at Abbott Northwestern Hospital and has provided outreach clinical services at New Ulm Medical Center (NUMC), part of Allina Health, for years.

Abbott Northwestern Hospital is the only facility in the state of Minnesota utilizing the Monarch robotic-assisted broncho-

scopy system. This equipment, developed by Auris Health, Inc., was purchased with the generous support of the Abbott Northwestern Hospital Foundation. The Monarch system is designed for diagnosing and staging cancers, Hovda explained, and in the future, it will be used to treat lung cancer as well.

“This technology allows us to get much farther into the lungs for biopsies. We have very precise control coupled with continuous visualization and this allows us to get an earlier and safer diagnosis of lung cancer,” Hovda said. “It’s much better and safer with a very low risk of complications while allowing us to diagnose these cancers earlier.”

Jonathan Hovda, MD, is a pulmonologist with the Minnesota Lung Center.

The procedure, performed at Abbott Northwestern Hospital, generally takes about an hour and is an outpatient procedure. The patient is fully sedated, Hovda said. “They are sleeping and don’t feel any discomfort during or after the procedure.”

The scope is inserted through the patient’s mouth and provides full, lighted visualization all the way through the complex branches of the lungs. The physician directs the robot and scope with a device that looks very much like a video game controller and is assisted by a 3D reconstruction of the lungs as well as the abnormal area which needs to be biopsied. Biopsy results are typically returned to the patient within two to three days.

November is Lung Cancer Awareness Month, which is a great time to remind people that up to two-thirds of new lung cancer diagnoses are in people who never smoked or who are former smokers, Hovda said.

“Lung cancer screening saves lives,” Hovda said. “Often, patients with lung cancer don’t have symptoms until later stage. Lung cancer screening, which is available at New Ulm Medical Center, is for patients over the age of 50 who used to smoke, or currently smoke.”

The screening involves a simple low dose CT scan of the chest, and this can be ordered after the patient and their primary care provider have a discussion about risk factors and symptoms. “If there is a spot identified in the lung, the scan is reviewed at a Thoracic Conference with all of the various specialists involved in lung cancer and a personalized plan is developed” Hovda said. Pulmonologists at Abbott Northwestern Hospital have performed approximately 175 cases since the technology was implemented in April 2019. Many of the patients who have benefitted from this new procedure are from New Ulm.

Kelsey Lindberg, NP, will begin seeing pulmonary patients in New Ulm this month on the third Tuesdays.

While patients will need to travel to Minneapolis for this procedure, Hovda said, “Initial consultation and follow-up visits take place at the NUMC clinic or via tele-health. The goal is to provide care as close to home and as conveniently as possible.”

That’s why Hovda has traveled to NUMC for years to provide pulmonology services to patients in the region. With demand for those services growing, Hovda will be joined in mid-November by Kelsey Lindberg, NP, also a provider at Minnesota Lung Center where she specializes in caring for patients with pulmonary and sleep disorders.

Dr. Hovda sees patients at NUMC on the first Thursday of the month, and Lindberg will be seeing patients on the third Tuesday of the month.

To schedule an appointment with either Dr. Hovda or Kelsey Lindberg, NP please call the NUMC appointment line at 507-217-5011.

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