A Review of Robotic-Assisted Bronchoscopy Platforms in the Sampling of Peripheral Pulmonary Lesions

Lu, Michael T.; Nath, Sridesh; Semaan, Roy

doi:10.3390/jcm10235678

Cited by 19 publications

(13 citation statements)

References 32 publications

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“…Initially in human cadavers, the PRECISE‐1 study reported a 100% rate of target localization and 80% of successful nodule puncture, both superior to EMB guidance and ultrathin bronchoscopy, 16 with similar rates reported by Chen et al 15 Recent human studies found comparable successful navigation, ranging from 88% to 98% using either EMB or shape‐sensing technology 24,25 . Reported diagnostic yield for RAB with or without R‐EBUS ranges from 69.1% to 88% 24,26–29 . We achieved a 100% rate of efficacy to reach and sample the target nodule, and an overall diagnostic yield of 87.6% for RAB.…”

Section: Discussionsupporting

confidence: 64%

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Robotic‐assisted bronchoscopy versus CT‐guided transthoracic biopsy for diagnosis of pulmonary nodules

et al. 2022

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Background and Objective Currently, computed tomography‐guided transthoracic biopsy (CTTB) is the most accurate diagnostic approach for pulmonary nodules suspected of malignancy. Traditional bronchoscopy has shown suboptimal diagnostic sensitivity, but the emergence of robotic‐assisted bronchoscopy (RAB) has the potential to improve diagnostic accuracy, maximize diagnostic yield and complete mediastinal and hilar staging in a single procedure. We aim to assess the efficacy and diagnostic performance of RAB compared to CTTB for diagnosing pulmonary nodules suspected of lung cancer. Methods A multicenter retrospective review of consecutive patients who underwent RAB and CTTB for evaluating pulmonary nodules from January 2019 to March 2021 at Mayo Clinic Florida and Mayo Clinic Rochester, United States. Clinical and demographic information, nodule characteristics, outcomes and complications were compared between RAB and CTTB. Results A total of 225 patients were included: 113 in the RAB group and 112 in the CTTB group. Overall diagnostic yield was 87.6% for RAB and 88.4% for CTTB. For malignant disease, RAB had a sensitivity of 82.1% and a specificity of 100%, CTTB had a sensitivity of 88.5% and a specificity of 100%. Complication rate was significantly higher for CTTB compared to RAB (17% vs. 4.4%; p = 0.002). Conclusion RAB, when available, can be as accurate as CTTB for sampling pulmonary nodules with similar or reduced complications and should be considered as a means for nodule biopsy, particularly when mediastinal staging is also clinically warranted.

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Section: Discussionsupporting

confidence: 64%

“…24,25 Reported diagnostic yield for RAB with or without R-EBUS ranges from 69.1% to 88%. 24,[26][27][28][29] We achieved a 100% rate of efficacy to reach and sample the target nodule, and an overall diagnostic yield of 87.6% for RAB.…”

Section: Discussionmentioning

confidence: 92%

Robotic‐assisted bronchoscopy versus CT‐guided transthoracic biopsy for diagnosis of pulmonary nodules

et al. 2022

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“…The ARCHIMEDES system has the advantage of additionally providing information regarding the surrounding vessels next to the lesion. Monarch is another platform regarded as a robotic-assisted method that we use under the guidance of computed tomography (11). In the case of a single nodule positive for NSCLC without distant metastasis, we can perform surgery or ablation.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Endoscopic radiofrequency ablation with radial-EBUS and ROSE

Hohenforst-Schmidt

Papadopoulos

Perdikouri

et al. 2023

Front. Med. Technol.

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BackgroundSingle pulmonary nodules are a common issue in everyday clinical practice. Currently, there are navigation systems with radial-endobronchial ultrasound and electromagnetic navigation for obtaining biopsies. Moreover, rapid on-site evaluation can be used for a quick assessment. These small lesions, even when they do not have any clinically significant information with positron emission tomography, are important to investigate.Case descriptionRadiofrequency and microwave ablation have been evaluated as local treatment techniques. These techniques can be used as therapy for a patient population that cannot be operated on. Currently, one verified operating system is used for endoscopic radiofrequency ablation through the working channel of a bronchoscope.ConclusionIn our case, a new system was used to perform radiofrequency ablation with long-term follow-up.

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“…Currently, only two platforms are available (Monarch and ION by Intuitive Surgical), with more to come [ 126 ]. Both devices’ steerable catheters have a small outer diameter, making it feasible for them to reach the peripheral areas of the lung, theoretically improving stability and control over traditional bronchoscopy and increasing diagnostic yield [ 126 ]. However, despite RB reaching deeper into the lung, lesion size still plays a role in diagnostic accuracy.…”

Section: Endoscopic Identification Of a Pplmentioning

confidence: 99%

Endoscopic Technologies for Peripheral Pulmonary Lesions: From Diagnosis to Therapy

Fantin¹,

Manera

Patruno³

et al. 2023

Life

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Peripheral pulmonary lesions (PPLs) are frequent incidental findings in subjects when performing chest radiographs or chest computed tomography (CT) scans. When a PPL is identified, it is necessary to proceed with a risk stratification based on the patient profile and the characteristics found on chest CT. In order to proceed with a diagnostic procedure, the first-line examination is often a bronchoscopy with tissue sampling. Many guidance technologies have recently been developed to facilitate PPLs sampling. Through bronchoscopy, it is currently possible to ascertain the PPL’s benign or malignant nature, delaying the therapy’s second phase with radical, supportive, or palliative intent. In this review, we describe all the new tools available: from the innovation of bronchoscopic instrumentation (e.g., ultrathin bronchoscopy and robotic bronchoscopy) to the advances in navigation technology (e.g., radial-probe endobronchial ultrasound, virtual navigation, electromagnetic navigation, shape-sensing navigation, cone-beam computed tomography). In addition, we summarize all the PPLs ablation techniques currently under experimentation. Interventional pulmonology may be a discipline aiming at adopting increasingly innovative and disruptive technologies.

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A Review of Robotic-Assisted Bronchoscopy Platforms in the Sampling of Peripheral Pulmonary Lesions

Cited by 19 publications

References 32 publications

Robotic‐assisted bronchoscopy versus CT‐guided transthoracic biopsy for diagnosis of pulmonary nodules

Robotic‐assisted bronchoscopy versus CT‐guided transthoracic biopsy for diagnosis of pulmonary nodules

Case Report: Endoscopic radiofrequency ablation with radial-EBUS and ROSE

Endoscopic Technologies for Peripheral Pulmonary Lesions: From Diagnosis to Therapy

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