Apr 27 2018
Mountain View Voice
The Monarch Platform made headlines for the first use of the technology at El Camino Hospital, located in Mountain View, California, as part of a clinical trial. El Camino’s clinical trial marks the first institution in the United States to use the Monarch Platform’s robotic technology for bronchoscopic procedures. Dr. Ganesh Krishna, the pulmonologist who performed the first case on March 30, 2018, believes the Monarch Platform marks a needed “paradigm shift” in the way physicians diagnose lung disease.
Unlike conventional bronchoscopic procedures, where the physician uses a manual bronchoscope, the Monarch Platform offers a familiar controller-like interface that physicians use to navigate the flexible robotic endoscope to the periphery of the lung with improved reach, vision, and control. It also offers real-time video and patient-centric navigational capabilities, a user-centric design for mobility and views into the lung with computer-assisted navigation based on 3-D models of the patient’s own lung anatomy, giving physicians continuous bronchoscope vision throughout the entire procedure.
Excerpts from the article: “He [Dr. Krishna] said using a conventional bronchoscope is subject to human error, challenging to maneuver, and is too large to fit in the smallest branches of the lungs, which poses a serious challenge in diagnosing potentially cancerous nodules in the lungs.”
"It [manual bronchoscope] can only go so far," Krishna said. "Periphery access has always been the Holy Grail."Read the Full Article
Complications from bronchoscopy are rare and most often minor, but if they occur, may include breathing difficulty, vocal cord spasm, hoarseness, slight fever, vomiting, dizziness, bronchial spasm, infection, low blood oxygen, bleeding from biopsied site, or an allergic reaction to medications. Only rarely do patients experience other more serious complications (for example, collapsed lung, respiratory failure, heart attack and/or cardiac arrhythmia).
Adverse effects from both Mini-PCNL and Ureteroscopy include pain, urinary tract infection, fever, hematuria (presence of blood in urine), exposure to low levels of radiation, retained or residual stones.
Adverse effects from ureteroscopy may include pain, perforation or injury to the ureter, resulting in extravasation of fluid and urine (urinoma), stricture of the ureter with risk of subsequent obstruction (hydronephrosis needing further repair), rare avulsion of the ureter, urinary blood clots, residual stones.
PCNL access may result in minor and major adverse effects. Minor effects include fever and nephrostomy leak. Major adverse effects may include injuries to pleura, liver, spleen, large vessels with related bleeding, gallbladder, duodenum, jejunum, colon with related cutaneous fistula, fever, pain, ileus, elevated counts.
Major adverse effects related to stone removal may include infection and urosepsis, intravascular fluid overload, extravasation of fluid, and post percutaneous nephrolithotomy bleeding.