Robotic Bronchoscopy for Peripheral Pulmonary Lesions: A Multicenter Pilot and Feasibility Study (BENEFIT)

Area of Science:

• Pulmonology
• Medical Technology
• Diagnostic Imaging

Background:

• Diagnosing peripheral pulmonary lesions (PPL) remains challenging, with limited improvement in diagnostic yield from traditional guided bronchoscopy.
• Robotic-assisted bronchoscopic platforms offer potential for improved PPL diagnosis, but clinical data are scarce.

Purpose of the Study:

• To evaluate the safety and feasibility of robotic-assisted bronchoscopy for diagnosing peripheral pulmonary lesions (PPL).

Main Methods:

• A prospective, multicenter pilot study involving 54 patients with PPLs (1-5 cm).
• Utilized a robotic bronchoscopic system with radial probe endobronchial ultrasound (R-EBUS) for lesion localization.
• Procedures included direct visualization, electromagnetic navigation, fluoroscopy, transbronchial needle aspiration (TBNA), and transbronchial biopsy if needed.

Main Results:

• Successful lesion localization was achieved in 96.2% of cases (51/53).
• The incidence of procedure-related adverse events was low (3.7% pneumothorax), comparable to conventional bronchoscopy.
• One case required tube thoracostomy for pneumothorax; no other adverse events were reported.

Conclusions:

• Robotic bronchoscopy is a safe and feasible option for diagnosing PPLs, demonstrating high localization success rates.
• The adverse event profile is similar to conventional bronchoscopy.
• Further large-scale prospective studies are needed to confirm diagnostic yield and optimize procedure characteristics.