Modesto hospital uses the ‘Ion Robot’ to find lung tumors and catch the disease early
Doctors Medical Center operates in a geographic region with elevated lung cancer rates and cancer mortality that’s well above the average in California.
The Modesto hospital recently invested in a robotic, noninvasive technology for biopsies of hard-to-reach lesions in the lungs and to remove suspected tumors early.
The Ion Robot increases the accuracy of biopsies that determine if a tumor is cancerous and assists with cutting out small lesions before they can grow larger, said Dr. Mohammed Abo Khamis, a pulmonologist who has utilized the Ion Robot at DMC since November.
“With the previous modality, an issue is how far it can reach inside the lungs and how accurate it is in obtaining biopsies,” Khamis said. “This is a game-changing technology. It allows us to get to anywhere inside the lungs and start treatment early. That improves the outcomes.”
Stanislaus County is in the second-worst tier for lung cancer incidence among California counties. The incidence rate, between 28.3 and 32.2 per 100,000 residents, is higher than in San Joaquin and Merced counties.
One reason may be cigarette smoking. While tobacco use has been down statewide, it has remained a habit for up to 17% of adult county residents since 2015, which is 47% higher than California’s rate, according to a Community Health Assessment for 2020. Lung cancer mortality has been the highest compared to other deadly cancers in Stanislaus County, per the California Department of Public Health.
The Ion robotic system, made by Intuitive Surgical in Sunnyvale, has a computer that takes 3-D images of a patient’s lungs to map the location of suspect lesions. A small scope with a camera at the tip is inserted through the patient’s mouth and into the bronchial tube.
Khamis stands at a controller and uses a joystick to maneuver the scope into the lungs. He said the system gives him an arrow that guides him to the lesion and also provides a good angle with tools to take tissue for examination. The procedure usually targets lesions in the lungs that are 6 to 8 millimeters or larger.
The robotic system tells the pulmonologist how far the scope is from the lesion and whether the doctor is getting close to anything that could put the patient at risk.
Following the biopsy procedure, a surgeon may be brought in to remove the small lesion during the same operation. Khamis can leave a marker on the legion so it’s easy for the surgeon to find.
“We can do multiple lesions at the same time and also look at the lymph nodes with another device,” Khamis pointed out.
The hospital says it’s the first in the Central Valley to use the Ion system and is part of the next wave of health care for lung cancer. More conventional methods of diagnosing the disease include a needle biopsy under local anesthesia, in which a needle stuck through the chest is guided by computed tomography to get a tissue sample.
Other procedures may use an endoscope inserted through the chest or into bronchial passages.
The DMC program is getting referrals from the Sacramento area to Fresno, as well as patients from Modesto, Stockton, Turlock, Sonora and Merced, a representative said.
Patients referred for a robotic bronchoscopy might have been screened for lung cancer because of age or a history of smoking tobacco, and a CT scan revealed a spot or spots on the lungs.
Cancerous tumor caught early for Valley resident
Kristi Tucker said that during a wellness checkup in September, her primary care doctor suggested a lung cancer screening due to a history of smoking. The 65-year-old Atwater resident said an imaging procedure detected a nodule on her lung and a PET scan found a small lump in her breast.
Dr. John deGraft-Johnson, a thoracic surgeon, used the Ion Robot for a biopsy of the lung nodule Nov. 19, which came back positive for cancer. The tumor was removed two days before Christmas.
Tucker said she never saw the robotic equipment but remembers seeing a room with “TV screens and a lot of people” before the anesthesia took effect.
“With the robot, everything is so precise,” Tucker said. “The precision is what I think helped me to heal so fast. It was about five days for healing.”
Tucker said she never had symptoms of lung cancer but is glad it was caught early. She noted she will need another surgery for the Stage 1 breast cancer.
Khamis said the Ion Robot improves the safety of lung biopsies and reduces complications. The complication risks of a standard biopsy or robotic procedure include bleeding, a punctured lung or air leak.
Intuitive says on its website that the Ion system, introduced in 2019, was designed to give patients with suspected lung cancer definitive answers without delays such as follow-up CT scans or multiple biopsies.
This story was originally published March 14, 2025 at 6:00 AM.
