St. Charles County Introduces Innovative Robotic-Assisted Lung Biopsy

Pulmonologists are advancing lung care in St. Charles County with the use of robotic- assisted biopsy technology. In June 2023, Barnes-Jewish St. Peters Hospital became the only hospital in St. Charles County and one of only two hospitals in the St. Louis region to offer a minimally invasive, robotic-assisted lung biopsy. This new technology allows for improved precision and efficiency in collecting lung tissue samples from patients.

With general bronchoscopy, the procedure pulmonologists use to look directly at the airways in the lungs and perform biopsies, only the larger airways of the lungs are accessible but the very small airways where abnormal, possibly cancerous, nodules cannot be navigated.Collecting lung tissue samples of suspicious nodules is critical in providing patients with an accurate diagnosis and effective treatment. Instead of a standard bronchoscope, robotic-assisted bronchoscopy utilizes a small 3.5mm flexible catheter equipped with a camera that can access the smaller parts of the lungs’ airways. A CT scan performed in advance provides a virtual map for the pulmonologist as they navigate these airways to the nodule using a rolling controller. The carefully choreographed procedure requires teamwork between physicians, pathologists, anesthesiologists, radiologists and endoscopy nurses.

Pulmonologist Scott Zuick, MD, and the Barnes-Jewish St. Peters Hospital endoscopy team helped bring this life-changing technology to St. Charles County. Dr. Zuick assisted in developing the hospital’s advanced diagnostic bronchoscopy program six years ago, and this is the next generation to access smaller and further nodules and ultimately provide even better care to patients.

“With the initial system, we couldn’t see the entire landscape of the lungs before, and it was much more difficult to access certain parts,” shares Dr. Zuick. “Bringing this advanced technology to our community was vital in allowing us to be more precise and ensure the highest level of lung care.”

When compared to traditional surgical procedures, robotic-assisted bronchoscopy is non-invasive, meaning it does not require any type of surgical incision in the skin. This typically results in a quicker and less painful recovery for patients. It also allows for other procedures to be performed simultaneously, such as biopsies and assessments of the lymph nodes, which would require additional invasiveness with other approaches.

Most importantly, robotic-assisted bronchoscopy offers patients greater safety. The lungs are like many small balloons, and when navigating the lungs, there is always a risk that one of these will pop or, when making incisions, that air could leak out and cause a complication called pneumothorax. With this new approach, pulmonologists can navigate through the already open airways directly to the lesion, which can significantly minimize those risks by almost 20 percent in some cases and decrease complications overall.

One of Dr. Zuick’s patients recently benefited from this state-of-the-art procedure.

Rita Morris, 71, of Wentzville, Missouri visited an urgent care in hopes of alleviating the persistent cough she experienced following a severe cold. Rita was told she needed to see a specialist. She was referred to Dr. Zuick, who performed a regular bronchoscopy to find an answer about the suspicious nodule on the left side of her lungs. However, there was one spot further down on the right side requiring a deeper biopsy to reach.

Dr. Zuick performed the new robotic-assisted procedure. From the patient perspective, it is a quick, 30-minute procedure utilizing general anesthesia, and because of its minimally invasive nature, Rita was able to go home the same day.

“Dr. Zuick and his team were always so thorough, kind and explanatory,” says Rita. “They even took me into the procedure room beforehand and showed me the robot.”

Unfortunately, RIta was diagnosed with stage 3 lung cancer. She was referred to Siteman Cancer Center in St. Peters, where she began receiving support from a Siteman Cancer Center nurse navigator whose role is to help guide patients through their treatment plan. Dr. Zuick collaborates closely with her oncology team — a continuity of care that allows for the most successful outcomes.

Despite her diagnosis and intensive treatment, which included a lung resection in September, Rita is in good spirits. She continues to enjoy traveling with her husband and is grateful for the exceptional care she is able to receive so close to home.

“Patients can get almost all of the care they could need here in St. Charles County,” says Dr. Zuick. “We’re very happy to provide the most advanced diagnostic techniques available, similar to that of an academic center, and this tool is here so we can identify these cancers at earlier stages when they can actually be treated successfully.”

To learn more about lung care in St. Charles County, visit bjsph.org/Medical-Services/Respiratory-Care