Mar 01 2019
The Monarch Platform was featured on the cover of the March-April 2019 issue of Oncology Issues. The journal, which is the official journal of the Association of Community Cancer Centers, was created for multidisciplinary oncology teams to provide information on a range of topics in cancer care.
In the March-April issue of the journal, the Monarch Platform was featured in an article titled “Robotic Bronchoscopy.” The article covered Fox Chase Cancer Center’s implementation of the Monarch Platform to help improve lung cancer diagnosis for their patients. The center began using the Monarch Platform to help diagnose small, hard-to-reach nodules in the periphery of the lungs. With early diagnosis and treatment of lung cancer, long-term results are greatly improved for patients.
Prior to implementing the Monarch Platform for lung nodule diagnosis, Dr. Christpher Manley, the Director of Interventional Pulmonology at Fox Chase in Philadelphia, traveled to the Auris headquarters in California several times over a 12-month period. There, he received formal training on the Monarch Platform, starting with using rubber and foam models and graduating to human cadavers, to learn how to use the Monarch Platform. After receiving this training, Dr. Manley and his team moved forward with implementing the technology at Fox Chase. Members of the Auris team flew out to Philadelphia with the Monarch Platform and worked closely with the Fox Chase staff to install the technology and educate the team.
Dr. Manley says Fox Chase has had great success since implementing the Monarch Platform. “We did six cases in our first two days. They went very smoothly, and we’ve been off and running since,” he said. Dr. Manley believes that this technology will work well for high-volume cancer centers with specialized, multidisciplinary teams, and will help them get earlier, more accurate diagnoses for patients quickly and safely. “All of these technologies that have come out in the last five years and especially the new robotic platform that we’re using at Fox Chase, I think it enables us to make those early impacts in a noninvasive way, and as the landscape continues to evolve, we’re going to be trying to bring technologies that benefit our patients.”
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.