Precision robotic biopsy, rapid diagnosis, and — if needed — lung-sparing surgery. No months of anxious waiting. One integrated private service, available within days.
Last reviewed: May 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382
Consultant-led scan review at first appointment → risk stratification → ION robotic biopsy where indicated → robotic lung-sparing surgery if cancer confirmed. One surgeon. No handoffs.
Private appointments within 2–3 days. Biopsy same day as decision to proceed. Surgical plan within days of cancer confirmation. No months of anxious waiting.
A definitive clinical decision at every stage — not a default to watchful waiting. Most patients are reassured and do not need surgery. Where surgery is right, it is the most precise option available.
The NHS Lung Cancer Screening Programme — delivered through targeted lung health checks to current and former smokers aged 55–74 — has fundamentally changed who is arriving in thoracic surgical clinics. Five years of programme data, published in Nature Medicine (March 2026), show that over 75% of screen-detected lung cancers are now found at Stage I or II — compared to fewer than 30% outside of screening.
This is genuinely important. Early-stage lung cancer is highly treatable. The surgery is less complex, recovery faster, and the chance of long-term survival dramatically greater. For patients with nodules found on screening, a positive result demands rapid, expert assessment — not weeks of uncertainty.
But the programme creates two new pressures. Around 15 in every 100 people scanned have lung nodules. Most are benign — but the NHS surveillance pathway typically involves a repeat scan weeks or months later, with no clear answer in the interim.
And for those confirmed to need surgery: the National Lung Cancer Audit 2026 found that 88% of patients with early-stage lung cancer waited longer than the recommended 49 days from referral to surgery — a direct consequence of screening-generated demand outpacing NHS surgical capacity.
A pulmonary nodule is a small, rounded area of tissue — typically less than 3cm — that appears as a white spot on a CT scan. It is one of the most common incidental findings in modern imaging, often discovered when scanning for something else entirely: a back injury, a cardiac check-up, a chest infection.
The reassuring truth is that the vast majority of lung nodules are entirely benign — traces of old infections, scar tissue, or small harmless growths. Only a small proportion represent early-stage lung cancer.
The challenge is that a single scan cannot always tell the difference with certainty. The most important question is not simply “is this cancer?” — it is “has this been properly assessed by the right specialist, as quickly as possible?” For a complete explanation of what a shadow on a lung scan means, see the lung shadow scan page →
For decades, the standard approach to a suspicious lung nodule was surveillance: repeat CT scans at three, six, and twelve-month intervals, monitoring for growth. This approach remains appropriate for genuinely low-risk nodules. But for those that warrant real concern — the right size, the right density, the right risk profile — months of repeat scanning can delay a diagnosis that could be made today.
The ION robotic bronchoscopy system changes that equation. A nodule that previously required months of surveillance to characterise can now be biopsied with precision — often as a day case — giving a definitive answer within days.
Designed to move quickly, spare lung tissue, and extend curative surgery to patients who might otherwise be told they cannot have it.
Rapid Specialist Assessment — in person, by Dr Okiror
Your CT scan is reviewed in detail — not just the report — alongside your clinical history, smoking background, and risk profile. Every scan is reviewed personally. You leave your first appointment with a clear plan. New patients are typically seen within 2–3 days.
ION Robotic Bronchoscopy & Biopsy
Using the ION endoluminal system — available at London Bridge Hospital, the first centre in Europe to offer it in routine clinical practice outside NHS research trials — an ultra-thin, robotic-guided catheter navigates deep into the lung, precisely to the nodule. A cone-beam CT scan confirms exact position before the sample is taken. A day case under general anaesthetic; most patients are home within hours. A small fluorescent dye marker is placed at the nodule site for surgical guidance if needed.
Learn more about ION bronchoscopy →Rapid Results & Certainty
If the biopsy confirms the nodule is benign, you have a definitive answer — without months of repeat scanning. If cancer is confirmed, treatment begins immediately rather than waiting weeks for the next referral in a chain. In most cases, you leave with a clear decision.
Lung-Sparing Robotic Surgery
Because these cancers are found small — at their earliest stage — surgery can be precisely targeted. The da Vinci robotic system’s infrared camera detects the fluorescent dye marker, guiding the resection to the exact site. For small tumours, this enables a segmentectomy — removing one segment rather than an entire lobe — preserving breathing capacity and keeping surgery an option for patients with emphysema or COPD. For a full discussion of robotic segmentectomy vs lobectomy and the trial evidence, see the robotic lung surgery page →
FRCS (CTh) — Fellow of the Royal College of Surgeons of England
FRCSEd (CTh) — Fellow of the Royal College of Surgeons of Edinburgh
Consultant Thoracic Surgeon, Guy’s and St Thomas’ NHS Foundation Trust — 99.59% operative survival rate vs 98.5% national average (SCTS National Audit 2024–25)
UK’s largest robotic thoracic surgery centre — 71.3% of anatomic resections performed robotically, more than double the national rate of 24%. Only 6% wedge resections vs 14% nationally
RCSEd Cardiothoracic Surgery Robotics Advisory Panel — Lead
Examiner — UK Intercollegiate Board in Cardiothoracic Surgery & European Board of Cardiothoracic Surgery
Over 30 peer-reviewed publications, book chapters and national research awards in minimally invasive lung cancer surgery and robotic technique
GSTT Outcomes — SCTS National Audit 2024–25
99.59%
Operative survival rate
vs 98.5% national avg
71.3%
Operations robotic
vs 24% nationally
6%
Wedge resections
vs 14% nationally
Figures relate to Guy’s and St Thomas’ NHS Foundation Trust, 2024–25. Operative survival = perioperative survival from lung resection surgery, not long-term cancer survival.
Ready for clarity?
Dr Okiror accepts a limited number of new private patients — appointments within 2–3 days