[Application of a novel robot-assisted navigation system in CT-guided percutaneous lung biopsy]

Objective: To compare the clinical efficacy and safety of robot-assisted navigation systems with those of the conventional puncture localization method in CT-guided percutaneous lung biopsy. Methods: We retrospectively collected clinical data from 140 patients who underwent CT-guided percutaneous lung biopsy at the Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Jianghan University, from January 6, 2021 to April 23, 2024. Among them, 103 patients were assigned to the manual operation group and 37 patients to the robot-assisted group. Propensity score matching was used to match the baseline characteristics of the two groups, with 29 patients included in each group for final analysis. Puncture time, procedure time, number of needle adjustments, number of CT scans, and incidence of complications were compared between the two groups. Results: After propensity score matching, the mean puncture time in the robot-assisted group was 6.59 minutes shorter than that in the manual operation group (15.72 min vs. 22.31 min, supplementary test value, P=0.012), and the mean procedure time was reduced by 4.99 minutes (24.62 min vs. 29.62 min, supplementary test value, P=0.069). The mean number of needle adjustments (1.03 vs. 2.69, supplementary test value, P=0.002) and the mean number of CT scans (4.31 vs. 6.55, P<0.001) in the robot-assisted group were both significantly lower than those in the manual group. Stratified analysis based on lesion location and size showed that for lower lung lesions, the mean puncture time was significantly shorter than that in the manual group (28.78 min vs. 16.6 min, P=0.04). For lesions larger than 30 mm, the mean puncture time (22.11 min vs. 12.92 min, P=0.006), number of needle adjustments (2.92 vs. 0.83, P<0.001), and number of CT scans (6.63 vs. 3.80, P<0.001) were all lower than those in the manual group, with statistically significant differences. Additionally, in the robot-assisted group, 7 patients (24.1%) used an out-of-plane needle positioning method, with intraoperative mean puncture time, procedure time, mean number of needle adjustments, and mean CT scans of 15.86 min, 23.71 min, 0.86, and 4.29, respectively. The incidence of bleeding complications in the robot-assisted group was lower than that in the manual group. Conclusions: Compared with the manual operation group, the robot-assisted group exhibited shorter mean puncture and procedure times, fewer needle adjustments and CT scans, a shorter mean puncture time for lower lung lesions, reduced mean puncture time along with fewer needle adjustments and CT scans for lesions larger than 30 mm, and a lower incidence of intraoperative bleeding.