Robotic assisted bronchoscopy for peripheral pulmonary nodules - data review

Robotic Assisted bronchoscopy has emerged as an important tool in diagnosing small peripheral lung nodules in the era of CT screening. This paper reviews results from recent publications.

Three meta -analyses have now been reported. Diagnostic yields reported in studies must be considered in terms of the study prevalence of malignancy, which if high tends to give higher overall diagnostic yield. Diagnostic yields are consistently an improvement on earlier technologies, particularly for lesions <20 mm in size. A range of imaging modalities have emerged as significant ways to improve diagnostic yield in Robotic procedures. These may be "stand alone" or integrated into the robotic systems. Robotic procedures may be performed under a single anaesthetic with planned surgical excision, the latter being guided by rapid on-site assessment or frozen section. Learning curve appears to be short and high levels of diagnostic performance with good safety profile have been reported.

Ongoing clinical study with robotic nodule biopsy will continue given the significant advance it has provided to clinicians in the first 5 years of its introduction.