The Use of Robotic-Assisted Bronchoscopy in the Diagnostic Evaluation of Peripheral Pulmonary Lesions: A Paradigm Shift

Altaq, Hiba Hammad; Parmar, M.; Hussain, Syed Afroze; Daouk, Salim; Chaudry, Fawad

doi:10.3390/diagnostics13061049

Cited by 5 publications

(7 citation statements)

References 27 publications

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“…A total of 26 studies were selected to review the full article. Of these, 16 studies were excluded: five studies did not report diagnostic results, 15 , 16 , 17 , 18 , 19 nine studies did not provide sufficient data to calculate the diagnostic yield according to our definition, 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 and two studies were excluded to avoid duplication of population. 29 , 30 Finally, 10 eligible studies with 725 lesions were included.…”

Section: Resultsmentioning

confidence: 99%

Robotic‐assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta‐analysis

Zhang,

Xie,

et al. 2024

Thoracic Cancer

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Robotic‐assisted bronchoscopy (RAB) is a newly developed bronchoscopic technique for the diagnosis of peripheral pulmonary lesions (PPLs). The objective of this meta‐analysis was to analyze the diagnostic yield and safety of RAB in patients with PPLs. Five databases (PubMed, Embase, Web of Science, CENTRAL, and ClinicalTrials.gov) were searched from inception to April 2023. Two independent investigators screened retrieved articles, extracted data, and assessed the study quality. The pooled diagnostic yield and complication rate were estimated. Subgroup analysis was used to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots and the Egger test. Sensitivity analysis was also conducted to assess the robustness of the synthesized results. A total of 725 lesions from 10 studies were included in this meta‐analysis. No publication bias was found. Overall, RAB had a pooled diagnostic yield of 80.4% (95% CI: 75.7%–85.1%). Lesion size of >30 mm, presence of a bronchus sign, and a concentric radial endobronchial ultrasound view were associated with a statistically significantly higher diagnostic yield. Heterogeneity exploration showed that studies using cryoprobes reported better yields than those without cryoprobes (90.0%, 95% CI: 83.2%–94.7% vs. 79.0%, 95% CI: 75.8%–82.2%, p < 0.01). The pooled complication rate was 3.0% (95% CI: 1.6%–4.4%). In conclusion, RAB is an effective and safe technique for PPLs diagnosis. Further high‐quality prospective studies still need to be conducted.

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Section: Resultsmentioning

confidence: 99%

Robotic‐assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta‐analysis

Zhang,

Xie,

et al. 2024

Thoracic Cancer

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“…However, a comparative cohort study showed that ssRAB and Digital Tomosynthesis-Electromagnetic Navigation Bronchoscopy (DT-ENB) had comparable diagnostic yields and safety profiles [13]. These studies show the diagnostic yield of ssRAB for peripheral pulmonary lesions ranging from 77% to 86% [6‒10, 13‒15]. However, there is little information on diagnostic yield of ssRAB for pure GGNs or SSNs specifically.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that using ssRAB has a high diagnostic yield, ranging from 79% to 93.3% [6][7][8][9][10]. ssRAB has also shown an exceptional safety profile [6].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Yield of Shape-Sensing Robotic-Assisted Bronchoscopy for Ground-Glass Nodules and Subsolid Nodules with a Solid Component Less than 6 mm

Abia-Trujillo,

Chandra,

Koratala

et al. 2023

Respiration

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Background: Ground-glass pulmonary nodules (GGNs) are most commonly sampled by percutaneous transthoracic biopsy. Diagnostic yield for ground-glass nodules using robotic-assisted bronchoscopy has been scarcely described, with a reported yield of 70.6%. Objectives: The aim of this study is to assess diagnostic yield for GGNs using shape-sensing robotic-assisted bronchoscopy (ssRAB). Method: A retrospective study of patients who underwent ssRAB for evaluation of GGNs, from September 2021 to April 2023. Primary outcome was diagnostic yield of ssRAB for GGNs, secondary outcomes were sensitivity for malignancy, and complications that required admission or intervention. Results: A total of 23 nodules were biopsied from 22 patients. Median age was 71 years (IQR 66–81), 63.6% were female, and 40.9% had a previous history of cancer. Forty-three percent of nodules were in the right upper lobes, and the median lesion size was 1.8 × 1.21. Twelve were subsolid nodules (SSNs), and 11 were pure GGNs. Overall diagnostic yield was 87%, with a sensitivity for malignancy of 88.9%. Adenocarcinoma was the most common malignancy diagnosed (70%). No procedure-related complications were reported. Conclusion: The use of ssRAB shows a high diagnostic yield for diagnosing GGN and SSN with less than 6 mm solid component with a low risk for complications.

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“…1). Component 1, the blue case with all the components inside, is reusable and houses two electric motors (3,4), specifically the Robotis Dynamixel AX 12A, along with the control boards (7), including the OpenCM9.04-C controller and the OpenCM845 expansion board (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

Design and Technical Feasibility Testing of a Medical Robot for Flexible Catheter Navigation Inside the Lung Airways

Gruionu,

Langø,

Leira

et al. 2024

Preprint

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The integration of medical robots, is revolutionizing clinical medicine, especially in procedures requiring precision in instrument manipulation and navigation within the body using medical imaging techniques like fluoroscopy, CT, and MRI. This is particularly challenging in peripheral lung lesion examinations, where guiding long, flexible instruments through the lung airways to the target exposes medical professionals and patients to harmful X-ray radiation. Several robotic approaches exist but there are still shortcomings in terms of their large footprint in the operating room and complex and costly mechanical structure. The goal of our research was to develop and test the early feasibility of RoboCath, an innovative robotic platform designed for the adaptable navigation of long, flexible catheter-like medical instruments through the lung airways. RoboCath seamlessly integrates with existing medical devices, such as bronchoscopes, facilitating access to lower lung regions with precision. Its compact design is ideal for crowded operating rooms, ensures sterilization compatibility, and supports a broad range of procedures, including those requiring intricate instrument manipulation and medical imaging for navigation. This technology significantly reduces the reliance on X-ray, thereby minimizing radiation exposure to both healthcare providers and patients. The RoboCath system represents a significant advancement in the field of medical robotics, offering a novel solution to the challenges of lung lesion biopsy and diagnosis, with potential applications in various open orifice procedures.

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The Use of Robotic-Assisted Bronchoscopy in the Diagnostic Evaluation of Peripheral Pulmonary Lesions: A Paradigm Shift

Cited by 5 publications

References 27 publications

Robotic‐assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta‐analysis

Robotic‐assisted bronchoscopy for the diagnosis of peripheral pulmonary lesions: A systematic review and meta‐analysis

Diagnostic Yield of Shape-Sensing Robotic-Assisted Bronchoscopy for Ground-Glass Nodules and Subsolid Nodules with a Solid Component Less than 6 mm

Design and Technical Feasibility Testing of a Medical Robot for Flexible Catheter Navigation Inside the Lung Airways

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