New Technology Helps Physicians Better Navigate to Hard-to-reach Areas in the Lungs

November 23, 2016

By Mercy's Jaclyn Bardin

After battling a cough for more than six weeks and undergoing imaging tests that revealed masses in Johnny Hanna’s lung and throat, the 45-year-old Coalgate resident was referred to the pulmonologists at Mercy Hospital Ardmore for a closer look at his lungs.

For the majority of patients, masses  are centrally located in their lungs. In these cases, Dr. Joel Sabangan, pulmonologist at Mercy Hospital Ardmore, performs a bronchoscopy to see inside the lung and remove a small tissue sample to test for cancer. During the traditional bronchoscopy procedure, doctors insert a 2-foot-long tube through the nose or mouth into the lungs that has a light, camera and surgical instrument for tissue removal.

Based on the location of the mass in the upper right side of Hanna’s lungs, Sabangan was not able to use the traditional method to reach Hanna’s mass. Luckily, there was an alternative.

Nearly two years ago, Mercy Hospital Ardmore invested in new bronchoscopy technology, called Electromagnetic Navigation Bronchoscopy (ENB). ENB helps doctors get to those hard-to-reach lung masses by using GPS-like technology to map the anatomy of the lung, bronchial tubes and airway. The pulmonologist then conducts the bronchoscopy using the map as a guide to maneuver the surgical instruments.

“The lung is a very intricate highway system and there are a lot of main highways, secondary highways and smaller streets,” said Sabangan. “This new technology tells you the best way to navigate those highways and streets to get to the right spot. Our goal is to get the diagnosis quickly so patients can start treatment right away if necessary.”

How it Works

Before performing the minimally invasive ENB procedure, the patient has a CT scan. The ENB machine uses the scan to create the map so doctors know the exact location they are trying to reach and how to get to it when performing the bronchoscopy procedure. The patient is able to go home the same day as the procedure.

For Hanna, the procedure was quick and easy with no recovery time.

“I felt great the next day,” he said. “As far as the procedure, I’d recommend it to anyone.”

Within a week, Hanna received his results. The mass was luckily not lung cancer. Instead, it was sarcoidosis — a disease that causes a collection of inflammatory cells that form lumps within the body. Hanna is now taking corticosteroids to treat the condition. He is still waiting for testing from another doctor related to the growth found in his throat.

New Technology, New Treatment Opportunities

If the ENB procedure was not available for patients with hard-to-reach growths in the lungs, a surgeon may have to surgically remove lung tissues to test for cancer, which is a more costly and painful procedure for patients.

The ENB technology is fairly new across the country and Hanna said he is thankful it is offered in Ardmore. 

“I think the bronchoscopy (ENB procedure) is a pretty good deal and everybody should be proud that they have it in this area because it’s not something that everybody has,” he said.

Other Options for Detecting Lung Cancer

While Sabangan and his team investigate growths or masses in the lungs after they’ve been discovered through imaging technology, a screening program at the hospital aims to catch lung cancers early.

Last May, Mercy Hospital Ardmore’s imaging services department began offering lung cancer screening exams for qualifying patients ages 55 to 77 who have smoked 30 pack years, which is about one pack of cigarettes a day for 30 years or two packs of cigarettes a day for 15 years. A physician’s order is required and the screening is only available to patients who have no signs or symptoms of lung cancer.

The CT scan for the screening uses a lower dose of radiation than a typical CT scan to get a clear picture of a patient’s lungs. The exam requires the use of a 16-slice CT scanner, which is not available in all hospitals, especially in rural areas.

“In lung cancer, you don’t usually have symptoms or they are mild until it has progressed,” said Heather Chatham, director of imaging services at Mercy Hospital Ardmore. “Doing this kind of scan for a high-risk population is really important and can save lives through early detection of cancer.”


To learn more about the ENB procedure at Mercy Hospital Ardmore, call 580-220-6300. For more information about the lung cancer screening exams, call 580-220-6162.

Nearly two years ago, Mercy Hospital Ardmore invested in new bronchoscopy technology, called Electromagnetic Navigation Bronchoscopy (ENB).
Nearly two years ago, Mercy Hospital Ardmore invested in new bronchoscopy technology, called Electromagnetic Navigation Bronchoscopy (ENB).

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