How the Ion Endoluminal System Works

Discover the Ion system

See the workflow that supports you from planning to completing a peripheral lung nodule biopsy. The journey begins with Ion’s planning station, which allows you to plan your path to the nodule. During the procedure, Ion guides you with precision along your preplanned path and allows you to park the catheter in place to perform the biopsy.¹ Integrated advanced imaging enables you to perform intraprocedural target updates and verify tool-in-lesion with confidence.²

Because Ion doesn’t rely on electromagnetic navigation, the system integrates into bronchoscopy suites and ORs without metal or ferromagnetic interference affecting the magnetic field.²

Plan your procedure

Your experience with Ion begins with PlanPoint software. PlanPoint integrates with your hospital network and PACS (picture archiving and communication system), allowing you to retrieve CT scans over the hospital network or directly from applicable imaging modalities.³

From the patient CT scan, PlanPoint generates detailed 3D airway trees and turn-by-turn navigation guidance to the target nodule, while also allowing you to create and compare alternate paths. Designed with patient safety in mind, PlanPoint automatically creates anatomy borders based on the nodule’s proximity to the pleura or fissure. It also gives you tools to mark additional anatomies of interest with user-defined borders or reference areas in and around the nodule.

PlanPoint helps enhance clinical confidence by amplifying visibility of critical structures, like vasculature, and allows you to adjust visual elements to your preference. Through the PlanPoint interface, you can review, edit, and finalize your plan for the procedure before securely transferring it over the hospital network to the Ion system.

Navigate to the lung nodule

During the bronchoscopy, use Ion’s controller to navigate to the lung nodule target along your preplanned path. With Ion’s ultrathin robotic catheter² and advanced maneuverability,¹ you can navigate far into the peripheral lung.²

The catheter, which has a 3.5 mm outer diameter and a 2.0 mm working channel, can articulate 180° in any direction and pass around tight turns, allowing it to reach all 18 segments of the lung.²

Ion’s fiber-optic shape sensor measures the full shape of the catheter, providing real-time precise location and shape information throughout navigation and biopsy.² With Ion’s vision probe, you have real-time vision of the airway while navigating to the target.² The camera provides a 120° field of view for navigation and a sharp videoscopic image for anatomy identification.⁴

Confirm the target

Ion's software includes several tools to help you navigate to the target nodule, which can be important if you encounter a difference in the nodule location seen in static preprocedural CTs and intraprocedural imaging (CT-to-body divergence).² The divergence assist feature helps you adjust for divergence with depth and rotation adjustments that align your navigation and live views. Once you reach the nodule, radial EBUS can be used to confirm your nodule location.

The Ion platform features multiple solutions to update your nodule location during a procedure, if needed. In addition to the powerful target update feature built into Ion’s core navigational workflow, the Ion platform enables further refinement via integration with mobile cone-beam CT and tomosynthesis advanced imaging solutions. These integrations allow you to correct for divergence in real time and verify tool-in-lesion following precise catheter adjustments.

Biopsy the lesion

Once the pulmonary nodule is reached, you can lock the catheter in place. A combination of the shape sensor’s real-time measurements with robotic control algorithms allows the catheter to hold its stable position.¹

Ion’s Flexision Needle was custom designed to pass through the catheter, even when positioned in tortuous airways. After advancing around tight-radius bends, the needle deploys into the target location on a straight path.

During biopsy, Ion’s biopsy marker feature lets you systematically track multiple biopsy attempts and helps you visualize different biopsy needle trajectories. If real-time confirmation of a representative tissue sample is available, you can redirect subsequent biopsy attempts into the confirmed target area. This approach is referred to as cloud biopsy.⁵

Integration and connectivity

Ion system in a suite integrated with Cios Spin

Technology integration

Ion is designed to fit easily into a bronchoscopy suite and integrate with existing technologies.² We also built Ion on an open-access⁶ platform to maintain your access to the latest technology breakthroughs. Ion currently integrates seamlessly with the Siemens Healthineers Cios Spin and CIARTIC move, as well as the GE HealthCare OEC 3D cone-beam CT systems. Ion is also compatible with a wide variety of 2D C-arms for its integrated tomosynthesis solution. The future holds many additional possibilities. We believe that innovation is key to advancing lung care outcomes, but we know that we’re not the only innovator in this space. We’re committed to keeping Ion an open-access platform because, as new ideas and technologies emerge, we believe in preserving your freedom to choose the right technologies for your patients.

Actionable insights from My Intuitive

My Intuitive provides a streamlined interface for you to input, track, and view data related to your Ion bronchoscopy practice. The platform automatically incorporates Ion system information and allows you to input additional case information, pathology results, staging information, and patient referral patterns.

My Intuitive also lets you review your data and discover unique, actionable insights. With trend reports and comparisons against national averages, My Intuitive can help you track your performance over time and communicate your outcomes to program stakeholders.

Instruments and accessories

ION FULLY ARTICULATING CATHETER

The catheter has a 3.5 mm outer diameter with 2 mm working channel and articulates 180° in any direction.

ION PERIPHERAL VISION PROBE

The vision probe fits within the tool channel of the Ion fully articulating catheter and provides a 120° field of view.

FLEXISION BIOPSY NEEDLE

The biopsy needle, available in 19G, 21G, and 23G, can extend up to 3 cm and is protected by a flexible retractable sheath, with a stylet for support during insertion.

Contact us

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Comparisons of precision, reach, and stability are relative to manual techniques. Comparisons of flexibility and maneuverability are relative to ENB technology. Precision is the ability to place a biopsy tool in the desired location consistently. Flexibility is the ability to articulate 180° in all directions. Reach is defined by airway generation access. Stability is enabled by fiber optic sensing technology which maintains active robotic control of catheter position and corrects unwanted tip deflection. Results based on internal testing. Data on file at Intuitive.
Results based on internal testing. Data on file at Intuitive.
Relative to manual transfer of the CT scan via CD or USB for procedure planning. Applicable for any device producing a CT scan meeting acceptable CT criteria.
Compared to the previous version of the Ion peripheral vision probe.
Cloud biopsy is Intuitive’s terminology for describing Ion’s ability to enable users to systematically perform biopsy attempts and redirect subsequent biopsy attempts into a target area if real-time confirmation of a representative tissue sample is available during a procedure.
"Open access" refers to the ability of the physician to use compatible tools with the Ion system; refer to the user manual for a list of compatible tools.

Disclosures and important safety information

Ion endoluminal system

As with any bronchoscopic procedure under general anesthesia, serious complications may include bleeding, pneumothorax (collapsed lung), cardiac-related complications, respiratory failure, air embolism, or death. For summary of the risks associated with bronchoscopy refer to www.intuitive.com/safety.

For risks, cautions, and warnings and full prescribing information, refer to the associated Ion System user manual(s) or visit https://manuals.intuitivesurgical.com/market.

Individuals’ outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics, and/or physician experience.

How Ion Works