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Review
. 2024 Aug 31;16(8):5422-5434.
doi: 10.21037/jtd-24-456. Epub 2024 Aug 28.

Robotic-assisted bronchoscopy: a narrative review of systems

Sebastian Fernandez-Bussy  1 , Nikitha C Chandra  1 , Anoop Koratala  1 , Alejandra Yu Lee-Mateus  1 , Alanna Barrios-Ruiz  1 , Ana Garza-Salas  1 , Tapendra Koirala  1 , Rodrigo Funes-Ferrada  1 , Prasanth Balasubramanian  1 , Neal M Patel  1 , Ryan Chadha  2 , Britney N Hazelett  1 , Kelly S Robertson  1 , Janani Reisenauer  3   4 , David Abia-Trujillo  1
Affiliations
Review

Robotic-assisted bronchoscopy: a narrative review of systems

Sebastian Fernandez-Bussy et al. J Thorac Dis. .

Abstract

Background and objective: Robotic-assisted bronchoscopy (RAB) has emerged as an advanced technology for lung cancer diagnosis. This review explores the three approved robotic bronchoscopy systems: Ion™ Endoluminal (Intuitive Surgical, Sunnyvale, CA, USA), Monarch™ (Johnson & Johnson, Redwood City, CA, USA), and Galaxy System™ (Noah Medical, San Carlos, CA, USA), and their different operational systems. This narrative review aims to summarize their findings and outcomes for sampling peripheral pulmonary lesions (PPL) suspected of lung cancer.

Methods: A search in PubMed and Google Scholar databases was conducted for articles and abstracts published between January 2018 to May 2024 using the terms "robotic bronchoscopy" or "robotic-assisted bronchoscopy" for biopsy of PPL.

Key content and findings: Lung cancer is the leading cause of cancer-related mortality. The introduction of RAB aims to improve the feasibility and safety of sampling PPL. Current literature describes high diagnostic yields with low risk of complications, allowing concurrent hilar and mediastinal staging within the same procedure. RAB can potentially improve early diagnosis and treatment of pulmonary malignancies and survival rate in long term, while progressing towards therapeutic applications in the near future.

Conclusions: As RAB evolves, its potential as a "one-stop shop" for diagnosis, staging, and treatment can positively impact lung cancer detection, focusing on improved patient-centered outcomes and reducing multiple diagnostic and therapeutic procedures.

Keywords: Robotic-assisted bronchoscopy (RAB); electromagnetic navigation (EMN); lung cancer; shape-sensing technology.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-24-456/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Ion™ Robotic Endoluminal System bronchoscopy. (A) Robotic arm, platform, and screen and trackball controllers (courtesy of Intuitive Surgical). (B) Trackball controllers and navigation screen. (C) Navigation display with 3-dimensional airway pathway in the upper screen, and mobile cone-beam computed tomography images in the axial, coronal, and sagittal view showing biopsy tool-in-lesion in the lower screen.
Figure 2
Figure 2
Monarch™ Robotic Endoscopy System bronchoscopy. (A) Tower and cart with robotic arms. (B) Controllers (courtesy of Johnson & Johnson).
Figure 3
Figure 3
The Galaxy System™ comprising of a single platform, arm, screen, and controller (courtesy of Noah Medical).
See this image and copyright information in PMC

References

    1. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin 2024;74:12-49. 10.3322/caac.21820 - DOI - PubMed
    1. Wolf AMD, Oeffinger KC, Shih TY, et al. Screening for lung cancer: 2023 guideline update from the American Cancer Society. CA Cancer J Clin 2024;74:50-81. 10.3322/caac.21811 - DOI - PubMed
    1. de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial. N Engl J Med 2020;382:503-13. 10.1056/NEJMoa1911793 - DOI - PubMed
    1. Pinsky PF, Church TR, Izmirlian G, et al. The National Lung Screening Trial: results stratified by demographics, smoking history, and lung cancer histology. Cancer 2013;119:3976-83. 10.1002/cncr.28326 - DOI - PMC - PubMed
    1. Fedewa SA, Bandi P, Smith RA, et al. Lung Cancer Screening Rates During the COVID-19 Pandemic. Chest 2022;161:586-9. 10.1016/j.chest.2021.07.030 - DOI - PMC - PubMed