Surgeons are hailing ‘a new era’ where patients with previously untreatable lung tumours can now be helped thanks to cutting-edge technology.
A patient at St Bartholomew’s Hospital in London was the first in the world to have their lung tumour treated using a unique combination of innovative techniques and technology which avoid puncturing the skin. The procedure combined the use of a hybrid surgical theatre equipped with the latest imaging devices, a catheter inserted through the mouth and guided using GPS-style images and finally a targeted dose of microwave energy, administered directly to the tumour without making a cut.
The combination paves the way for many patients previously deemed too unfit to have the usual more invasive operation to undergo the procedure.
The new equipment* was funded by Barts Charity to replace the current method, which involves puncturing the lung through the skin and muscles. This can be painful and up to half of all patients will suffer a collapsed lung, with others experiencing internal bleeding.
The innovative method uses software to create a 3D ‘map’ of the lung and guides surgeons as they pass a catheter through the patient’s mouth and airways, making the correct twists and turns along the way, to safely reach the tumour.
The procedure was carried out by Mr Kelvin Lau, consultant and lead for thoracic surgery at Barts Health NHS Trust, who explained: “This heralds a new era where more patients can potentially be cured for their lung cancer. Currently, one in five patients with potentially curable lung cancer are not fit enough to undergo the standard treatment of operation or radiotherapy, but we can now treat these patients using navigational bronchoscopy. I am absolutely delighted.”
“Navigational bronchoscopy allows us to safely and painlessly reach the tumour, without using cuts or needles, or needing to puncture the lungs.”
Anna Szot-Czetowicz, 65, from London, recovered immediately without any pain or discomfort and was ready to go home the following day, far quicker than the usual procedure. Experts say if she had undergone an operation to cut out the tumour, she would have lost a lot of lung and her breathing would have been impaired.
Anna said: “If I wasn’t in hospital, I wouldn’t have known I’d had an operation. I feel physically and psychologically fantastic. Mr Lau and the team are lovely; I am so grateful. I was surprised to hear I’d be the first patient, but I am pleased that because of me they can now operate on other patients and help them too.”
The new procedure was performed in a so-called hybrid operating room, which was equipped with an advanced interventional X-ray system capable of acquiring live 3D images of lung anatomy and the interventional instruments. The 3D imaging capability enables surgeons to see clearly what is happening inside the body as the tumour is irradiated with a precise dose of microwave to over 100 degrees.
The superDimension™ navigational bronchoscopy and the Emprint™ microwave ablation technologies are developed and manufactured by Medtronic. The hybrid operating room and 3D imaging software are developed and manufactured by Philips.
St Bartholomew’s Hospital was the first hospital in Europe to use the latest navigational bronchoscopy equipment to carry out biopsies, thanks to £145,000 of funding from Barts Charity.
Fiona Miller-Smith, Chief Executive of Barts Charity, said: "We are thrilled that the charity’s funding has been used to purchase this equipment, which is increasing the treatment options available to patients with lung cancer. We are proud to support ambitious and forward-thinking surgeons like Mr Lau who are pushing the boundaries of cancer treatment.”
Ronald Tabaksblat, Business Leader Image Guided Therapy Systems at Philips said: “At Philips we are committed to improve patient outcomes and enhance care pathways. Lung cancer is a complex disease and we are motivated to give patients access to a new minimally-invasive treatment options like this successful first procedure.”
“We are delighted with this remarkable milestone and glad that Philips’ imaging technology and visualization software in the hybrid OR was an important enabler. We look forward to continuing the ground-breaking collaboration with St Bartholomew’s hospital and stay committed to improving the journey of patients affected by lung cancer.”