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 tools that allow you to plan and navigate your path to the nodule.¹ As your guided catheter approaches the nodule, you can confirm tool-in-lesion accuracy with integrated 3D imaging.²

When you’re ready, Ion allows you to park the catheter in place to perform the biopsy.¹ 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 pre-planned 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 When using radial EBUS, Ion provides guidance to streamline target identification.² With external cone-beam CT (CBCT) imaging, Ion can mark the current catheter position in the 3D biopsy view.²

When using integrated Cios Spin or OEC 3D CBCT imaging, Ion receives 3D images on demand during the procedure. This allows you to update target locations and helps you make precise¹ catheter adjustments based on the provided intraprocedural 3D images. Preliminary results of a multicenter study evaluating the integration of Ion and Cios Spin show that tool-in-lesion (TIN) was achieved in 99.4% of cases, with an average of two CBCT spin (including TIN confirmatory spin). Strict diagnostic yield was approximately 90%.⁷ Learn more about the CONFIRM study and other recent clinical evidence on the Research and Outcomes page.

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 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 both Siemens Healthineers Cios Spin and GE HealthCare OEC 3D cone-beam CT imaging. Ion also leverages existing imaging technologies with radial endobronchial ultrasound (rEBUS), fluoroscopic, virtual, and live views of the airways unified in a single system.²

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, including instrument utilization, procedure events, pathology results, and patient referral patterns.

My Intuitive also lets you review your data and gain 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 practice 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.
Strict diagnostic yield was calculated at index biopsy using the sum of specific benign and malignant findings divided by all nodules.

Disclosures and important safety information

Ion endoluminal system

The Ion Endoluminal System (Model IF1000) assists the user in navigating a catheter and endoscopic tools in the pulmonary tract using endoscopic visualization of the tracheobronchial tree for diagnostic and therapeutic procedures. The Ion Endoluminal System enables fiducial marker placement. It does not make a diagnosis and is not for pediatric use.

Information provided by the Ion endoluminal system or its components should be considered guidance only and not replace clinical decisions made by a trained physician.

For summary of the risks associated with bronchoscopy refer to www.intuitive.com/safety.

The Flexision Biopsy Needle is used with the Ion Endoluminal System to biopsy tissue from a target area in the lung.

The PlanPoint Software uses patient CT scans to create a 3D plan of the lung and navigation pathways for use with the Ion Endoluminal System.

How Ion Works