A leading Abu Dhabi hospital has introduced a robot-assisted device to help boost lung cancer detection as part of a cutting-edge drive to improve patient care and save lives.
Cleveland Clinic Abu Dhabi has become the first in the Middle East to use a high-tech bronchoscopy tool that allows doctors to make swift and accurate diagnoses without the need for open surgery.
The Monarch platform enables access to the smallest lung nodules – round masses of tissue that can be cancerous – in a minimally invasive procedure that can be performed in 30 to 75 minutes under general anaesthetic.
It is used by doctors to guide a flexible endoscope deep into the lungs to access nodules that may previously been out of reach.
The technology has been rolled out with the support of Abu Dhabi's Department of Health.
As well as supporting early identification of lung cancer at stage 1 – where the five-year survival rate exceeds 70 per cent, it can be used to diagnose lung nodules arising from cancer that has metastasised to the lungs, benign lung nodules, infections such as tuberculosis, and inflammatory lung diseases.
“By investing in advanced, technology-enabled solutions, we are redefining patients’ experience through safer, less invasive care while also enhancing diagnostic accuracy,” said Dr Georges-Pascal Haber, chief executive of Cleveland Clinic Abu Dhabi.
“Robotically-assisted bronchoscopy represents a breakthrough in how we detect and diagnose lung disease,” said Dr Zaid Zoumot, division chair of pulmonary medicine at Cleveland Clinic's Integrated Hospital Care Institute.
“For the first time, we can precisely access and biopsy even the smallest, most difficult-to-reach lung nodules, enabling diagnosis at earlier stages where lung cancer is most treatable, and outcomes are better.”
How does Monarch work?
The Monarch platform was developed by Johnson & Johnson MedTech, a global leader in healthcare technology.
“The key takeaway is that you are now able to diagnose nodules that you would not have been able to diagnose before,” said Peter Lane, surgery general manager for the Middle East and Africa at Johnson & Johnson MedTech.
“You end up with nodules that are very peripheral on the lung and very hard to reach. You wouldn’t have been able to get there with traditional technology.”
The platform uses a patient’s CT scan to create a three-dimensional map of the lungs and airways to identify the best route to the target lesion.
Doctors then guide the bronchoscope through the lungs while watching its progress on a screen, before taking the biopsy.
“It creates a whole navigation system, shows all of the lungs and airways, maps out the best route and gives you a three-dimensional view of the nodule,” Mr Lane said.
“When you target that nodule for a biopsy, you can make sure you’re getting to the very centre of it, which is really important to get the correct diagnosis.”
He said the technology had already been used to support patients at Cleveland Clinic who otherwise might have faced a longer wait for treatment.
“Two of those patients had a successful identification. That happens there and then in the operating room. Both of those patients then went to theatre, had surgery and they’re recovering right now,” he said.
Doctors have traditionally carried out bronchoscopy by manually guiding a flexible camera through the airways while relying on CT scans, live imaging and their own judgment to reach a suspicious nodule.
As the airways become narrower towards the edge of the lungs, reaching small, peripheral nodules becomes increasingly difficult.
Patients with suspicious nodules that could not be reached through conventional bronchoscopy might have to undergo other procedures or return for repeated scans to see whether the lesion had grown.
Supporting patients
“When it comes to cancer, certainly as a patient, you feel like every second counts,” Mr Lane said.
“Now what we can do is have earlier identification, which then leads to more options for the patient, whether that is surgical intervention or via drugs.”
A study into the Monarch device, which involved 679 patients in the US, Canada and Hong Kong, found it reached targeted nodules in 98.7 per cent of procedures.
Johnson & Johnson said previous research suggested the technology could help patients to start lung cancer treatment an average of three weeks early.
Lung cancer remains the leading cause of cancer death worldwide. Almost 2.5 million people were diagnosed with the disease and more than 1.8 million died from it in 2022, according to the International Agency for Research on Cancer.
Early-stage lung cancer often causes no symptoms, making early diagnosis particularly important.
Mr Lane said the UAE was chosen for the regional launch because of its healthcare infrastructure, specialist workforce and willingness to adopt new medical technologies.
“This is about the incredible system that the Middle East has provided from a healthcare infrastructure and a leadership position on technology.”
He said Abu Dhabi had created an environment in which regulators, hospitals and medical companies could work together more quickly than in many other countries.
“They’re creating the ecosystem for this and becoming a reference centre for the world.”
