To our knowledge, this is the first reported case of successful
transbronchial biopsy via RB in a 5-year-old patient. The sample
revealed a potential diagnosis, but more importantly, helped rule out an
active infectious process and avoided an open lung biopsy which was
being planned and would have otherwise been necessary to establish a
diagnosis. We believe this technology can be used to increase the
diagnostic yield of flexible bronchoscopy, particularly in the
immunocompromised population as there is already evidence supporting
image-guided bronchoscopy over conventional bronchoscopy in this
population [(4)](#ref-0004). A notable limitation to RB is the size
of the available bronchoscopes for robotic platforms (4.5 and 3.5 mm
OD). In children, this may limit the capacity to sample more peripheral
lesions via fine needle aspiration, as more lung tissue (relative to
chest size) may be injured. In our case, the catheter tip was never as
close to the lesion as it has been described in adults
[(2)](#ref-0002). As the field of pediatric interventional
pulmonology continues to develop, RB will likely be one of several
options available for safe and high-yield diagnostic procedures.
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