2021
DOI: 10.1016/j.chest.2020.08.2047
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Robotic Bronchoscopy for Peripheral Pulmonary Lesions

Abstract: BACKGROUND: The diagnosis of peripheral pulmonary lesions (PPL) continues to present clinical challenges. Despite extensive experience with guided bronchoscopy, the diagnostic yield has not improved significantly. Robotic-assisted bronchoscopic platforms have been developed potentially to improve the diagnostic yield for PPL. Presently, limited data exist that evaluate the performance of robotic systems in live human subjects. RESEARCH QUESTION: What is the safety and feasibility of robotic-assisted bronchosco… Show more

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Cited by 174 publications
(111 citation statements)
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“…A recent study showed that even with newly developed robotic bronchoscopy, 3.7% of patients are complicated with pneumothorax [ 21 ]. This report and our study suggest that it is difficult to completely prevent pneumothorax, even when TBB is performed using an advanced tool or technique.…”
Section: Discussionmentioning
confidence: 99%
“…A recent study showed that even with newly developed robotic bronchoscopy, 3.7% of patients are complicated with pneumothorax [ 21 ]. This report and our study suggest that it is difficult to completely prevent pneumothorax, even when TBB is performed using an advanced tool or technique.…”
Section: Discussionmentioning
confidence: 99%
“…Radial endoscopic ultrasound (R-EBUS), fluoroscopy, CT, cone beam CT or a combination of R-EBUS and radiology imaging are used to confirm position prior to sampling. [189][190][191][192][193][194][195][196][197][198] A meta-analysis of R-EBUS showed a pooled sensitivity of 0.72 (95% CI 0.70-0.75). 199 Significant study heterogeneity was noted.…”
Section: Section 6 Diagnostic Methods For Screen-detected Lung Nodulesmentioning
confidence: 99%
“…205,206 The clinical utility of newer technologies such as robotic bronchoscopy or Transparenchymal Nodule Access (TPNA) to improve diagnostic yield is currently under investigation. [195][196][197] Recommendations regarding the optimal approach to biopsy peripheral lung nodules is limited by a paucity of randomized comparative studies of different technologies or approaches, and lack of health economic analyses. Information on the diagnostic yield of the investigators prior to testing the new technologies and their procedural volume would be useful for evaluating how transferrable these technologies are in the community.…”
Section: Section 6 Diagnostic Methods For Screen-detected Lung Nodulesmentioning
confidence: 99%
“…Factors predicting diagnostic yield include the presence of a bronchus sign and lesion size ≄10 mm (3)(4)(5). The bronchus sign may not always be appreciated during pre-procedural planning since the airway is not always visualized due to the lack of contrast between the bronchus and surrounding emphysematous lung parenchyma.…”
mentioning
confidence: 99%
“…This maneuver of gently advancing the scope in the peripheral airways without tactile feedback may be concerning as it could theoretically lead to significant airway trauma followed by pneumothorax or bleeding. That being said, published human trials have demonstrated overall safety of a RAB platform, with complication rates comparable to conventional bronchoscopy (3,4). There are no published reports of airway bleeding that have required the use of blood transfusion, open thoracotomy, or the use of endobronchial blockers (3,4).…”
mentioning
confidence: 99%