UK HealthCare’s Interventional Pulmonology program has proudly announced the successful completion of 1,000 shape-sensing robotic-assisted bronchoscopies (ss-RAB), less than three years from the procedure’s first occurrence within the facility.
“We’re trying to diagnose cancer in its earliest stages,” said Bronchoscopy and Interventional Pulmonology Director Ashish Maskey, MD. “We’re going after smaller and smaller disease. Right now, the nodules are often one centimeter, about the size of a pea.”
The procedure is performed under general anesthesia. The robot, in the shape of a catheter approximately the width of a chopstick, advances through the breathing tube and into the airways. It has a camera to visualize the airway and maintains navigation guidance with the help of an airway map created with the patient’s chest CT scan. Smaller airways are navigated until the target is reached.
“The virtual image guides us through the network of airways within the lung,” said Dr. Maskey. “Once we’re at the nodule’s location, we use a special imaging technique called a cone beam CT scan to confirm the shape in a three-dimensional view. When we’re convinced that we see the tumor on an ultrasound, that’s when we biopsy."
Once the potentially cancerous nodule is biopsied, an ultrasound guided bronchoscopy can help identify the stage of the patient’s cancer by reaching nearby enlarged lymph nodes. The nodes are biopsied in the same sitting, allowing for a treatment plan to take shape much faster.
Not only does ss-RAB provide a rapid turnaround for cancer treatment, but it also reduces procedural risks during bronchoscopies. Prior to the implementation of the ss-RAB, a biopsy guided by CT-scan alone had a 17% chance of lung collapse. Today, that number has fallen to just 2.3% with robot assistance, providing a safer patient experience.
“The complication rates are very low. The robot makes the procedure easier, because we have more stability. We can go after nodules that are farther, smaller and more difficult,” said Dr. Maskey.
According to the American Lung Association, Kentucky ranks first in the United States for new cases of lung cancer. An average of 84.1 people per 100,000 will be diagnosed with the disease. However, just one in four patients who qualify for lung cancer screening complete the evaluation. Dr. Maskey urges patients to follow through on what could be a life-saving decision.
“We encourage everyone to get their lung cancer screened. For every 320 patients screened, we will save one life,” he said.
Interventional pulmonology is a relatively new medical subspecialty. Board certification in the field didn’t become formalized until 2012. In 2025, approximately 40 physicians graduate from an interventional pulmonology fellowship each year.
“It’s still a pretty exclusive field. Our goal is to train more physicians and expand the role of interventional pulmonology through education, training, and collaboration with other medical facilities. We work with thoracic surgeons, radiation oncologists and interventional radiology to provide more efficient care and reduce time from diagnosis to treatment for lung cancer,” said Dr. Maskey.
UK HealthCare’s Interventional Pulmonology program continues to grow at a steady pace. They currently have three full-time physicians: Dr. Maskey, Dr. Scott Yee and Dr. Brenda Garcia. Together, these physicians and their health care team are accelerating care and reaching a larger patient population.