Novel approaches utilizing robotic navigational bronchoscopy: a single institution experience

The effective biopsy of pulmonary nodules is crucial to early diagnosis and consequent effective treatment for patients. As a relatively new procedure, few studies look at the effectiveness of the Monarch system in achieving this goal. The aim of this study is to describe the validity of the Monarch-guided robotic navigational bronchoscopy as an effective diagnostic method for pulmonary disease. A secondary aim is to describe the validity of dye localization using the robotic platform to improve the diagnostic accuracy of surgical biopsies in suspicious subcentimeter nodules. This observational cohort study includes patients who underwent robotic navigational bronchoscopy at John Muir Health between July 8, 2020 and October 11, 2021. Some underwent the navigational bronchoscopy in conjugation with a dye localization procedure. Patient data were collected from the institutional database. We measured specificity, sensitivity, and likelihood ratios. A total of 69 patients underwent robotic navigational bronchoscopy. The procedure had a specificity and sensitivity of 100% and 91.3%, respectively. Additionally, 28 patients underwent robotic navigational bronchoscopy in conjugation with dye localization. The specificity and sensitivity for the combined procedures was 100% and 100%, respectively. Robotic Navigational Bronchoscopy can be a successful diagnostic technique to diagnose pulmonary disease quickly and accurately. The technique allowed for the effective biopsy of traditionally difficult to access nodules. Additionally, by combining dye localization techniques, surgical biopsy of the nodules significantly improved the diagnostic accuracy. This single anesthetic event can potentially lead to earlier diagnosis, staging, and treatment of early stage lung cancers.