Robotic-assisted bronchoscope achieves diagnostic yield more than three times higher than conventional bronchoscopy for peripheral pulmonary lesions
TUESDAY, Oct. 7, 2025 (HealthDay News) — A robotic-assisted bronchoscope (RAB) can reach very small tumors growing in hard-to-reach parts of the lung, according to a study presented at the annual congress of the European Respiratory Society, held from Sept. 27 to Oct. 1 in Amsterdam.
Carolin Steinack, from University Hospital Zürich, and colleagues randomly assigned 78 patients with peripheral pulmonary lesions (PPLs) in 1:1 fashion to undergo either conventional bronchoscopy (CB) with ultra-thin bronchoscopes and 2-dimensional (2D) fluoroscopy or shape sensing-RAB with cone-beam computed tomography (SS-RAB+CBCT). The researchers found the diagnostic yield was 23.1 percent for CB versus 84.6 percent for RAB+CBCT. For nondiagnostic CB cases, 92.9 percent (26 of 28) were successfully diagnosed through subsequent RAB+CBCT during either the same anesthesia event or a separate procedure. Overall, more than half of cases (53.5 percent) were diagnosed with lung cancer (39.4 percent with stage IA). The groups were similar with respect to overall rate of adverse events.
In a second retrospective cohort study, the same researchers compared PPL diagnostic yield (12-month follow-up) across three sequentially implemented platforms: virtual navigation bronchoscopy (VNB) with 2D fluoroscopy (2021–2022), electromagnetic navigation (EMN) bronchoscopy with 2D fluoroscopy (2023–2024), and RAB+CBCT (2024). RAB+CBCT had the highest diagnostic yield (89.3 percent), significantly outperforming VNB (47.4 percent) and EMN (45.5 percent). The highest pneumothorax rates were seen for EMN (8.5 percent), followed by RAB+CBCT (1.4 percent) and VNB (0 percent).
“In centers that see lots of patients with these tumors, I believe the benefits of this technology justify the investment,” lead author Thomas Gaisl, also from University Hospital Zürich, said in a statement. “However, the robotic system should be reserved for small, hard-to-reach lesions, where conventional bronchoscopy is not an option.”
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