How the Ion Endoluminal System Works (2025)

The biopsy journey begins with planning a guided path to the lung nodule using patient CT scans. These can be created and edited prior to the lung biopsy. During the biopsy, the Ion Endoluminal System provides real-time, GPS-like navigation to the lung nodule.¹

Ion allows the catheter to be parked 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

Biopsy planning with PlanPoint

The experience with Ion begins with our PlanPoint software. PlanPoint’s integration with PACS (Picture Archiving and Communication System) allows for secure and efficient retrieval of CT scans over the hospital network or directly from applicable imaging modalities.³

Starting with selection of the target lung nodule from the patient CT scan, PlanPoint generates 3D airway trees and automatically creates a path to the nodule. Review, edit, and finalize plans to be used during the procedure through the PlanPoint interface.²

Navigate to the lung nodule

During the bronchoscopy, Ion’s controller is used to navigate to the target nodule along a pre-planned path. With Ion’s ultrathin robotic catheter² and advanced maneuverability,¹ navigation far into the peripheral lung is made possible.²

Ion’s vision probe enables real-time vision of the airway while navigating to the target nodule.² The camera provides a 120° field of view for navigation and a sharp videoscopic image for anatomy identification.⁴

During navigation, virtual and live camera views can be synchronized.² Ion’s compass feature translates the direction of the catheter to anatomical directions.² As a result, pulmonologists experience real-time, turn-by-turn navigation through the lung’s airways.⁵

Confirm the target

Ion's software includes several navigation tools to reach the target nodule. This can be important when encountering 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 When using external cone-beam CT (CBCT) imaging, Ion can mark the current catheter position in the 3D biopsy view.²

When using integrated Cios Spin mobile imaging, Ion receives 3D images from Cios Spin on demand during the procedure. This allows updated targeting locations and assists in making precise6 catheter adjustments based on the provided intraprocedural 3D images. In preclinical testing, Ion integration with Cios Spin enabled tool-in-lesion accuracy of 100% in an average of 1.41 spins.⁷

Biopsy the lesion

Once the pulmonary nodule is reached, the catheter can be locked 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 allows systematic tracking of multiple biopsy attempts, and enables visualization of different biopsy needle trajectories. If real-time confirmation of a representative tissue sample is available, subsequent biopsy attempts can be redirected into the confirmed target area. This approach is referred to as cloud biopsy.⁸

Technology integration

Ion is designed to fit easily into a bronchoscopy suite and integrate with existing technologies.² Physical proximity has been taken into account with a design that keeps you close to the patient’s airways throughout the procedure.

Although Ion does not require the use of CBCT for nodule biopsy, Intuitive designed the system to be compatible with external CBCT² and provide integrated connectivity with Cios Spin mobile imaging. Ion integration with Cios Spin allows system components to be positioned without physical interference. 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

Ion fully articulating catheter

The catheter has a 3.5 mm outer diameter with a 2 mm working channel and articulates 180° in any direction.

Ion peripheral vision probe

The vision probe fits within Ion’s fully articulating catheter and provides a 120° field of view.

Ion Flexision biopsy needle

The Ion Flexision 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.

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