The evolution of interventional pulmonology from rigid bronchoscopy to robotics

Interventional pulmonology has evolved over the past century from rudimentary endoscopic procedures to a highly specialized discipline encompassing a wide range of diagnostic and therapeutic techniques. This review outlines the historical milestones that have shaped the field, tracing the progressive development of flexible and rigid bronchoscopy, thoracic ultrasound, robotic systems, and advanced imaging modalities such as cone-beam CT. Each innovation has contributed to enhancing the accuracy, safety, and efficacy of interventions for various pulmonary diseases, including malignancies, interstitial lung disease, airway obstruction, and pleural disorders. The review also explores the role of pioneering figures whose vision and experimentation laid the foundation for modern practices. From Killian's first bronchoscopic foreign body removal to the latest robotic navigation systems, the trajectory of interventional pulmonology illustrates a dynamic interplay between technological advancement and clinical need.