Related Experiment Video
Updated: May 26, 2026
Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
Published on: May 4, 2022
Shape-sensing robotic-assisted versus electromagnetic navigation bronchoscopy for peripheral pulmonary lesions: a
Paras M Patel1,2, Vivek Athipatla3, Susmita Potti4
1Division of Interventional Pulmonology, Department of Internal Medicine, JPS Health Network, Fort Worth, TX, USA.
Background:
Electromagnetic navigation bronchoscopy (ENB) and shape sensing robotic assisted bronchoscopy (ssRAB) are used to sample peripheral pulmonary lesions (PPLs). Comparative data between ENB and ssRAB, particularly in the absence of advanced three-dimensional imaging, remain limited. We compared the performance of ENB and ssRAB performed by a single interventional pulmonologist at a large urban hospital.
Methods:
We performed a single-center retrospective analysis of ENB procedures performed between December 2020 and June 2023 and ssRAB procedures performed between September 2023 and August 2024. All procedures used radial endobronchial ultrasound and two-dimensional fluoroscopy. Neither modality was used with cone beam computed tomography (CT), digital tomosynthesis, or rapid on-site evaluation. Diagnostic yield, final diagnostic accuracy, number of procedures required to establish a diagnosis of malignancy, and complications were compared.
Results:
A total of 359 patients were included (ENB 226; ssRAB 133). Strict diagnostic yield from the index procedure was 64% for both technologies. Final diagnostic accuracy was 71.2% for ENB and 76% for ssRAB (P=0.39). Patients undergoing ssRAB required fewer procedures to establish a malignant diagnosis, with 84.6% diagnosed after a single procedure compared with 60.8% for ENB (P=0.007). PPLs sampled with ssRAB were smaller than those sampled with ENB (median size 1.7 vs. 2.4 cm, P<0.001). Pneumothorax occurred in two ENB cases and one ssRAB case, with an overall complication rate of <1%. Time from initial chest CT to biopsy was similar between groups.
Conclusions:
In this single operator, large hospital experience, ssRAB achieved similar diagnostic yield to ENB while sampling smaller PPLs and requiring fewer procedures to obtain a final malignant diagnosis. These findings suggest the feasibility of integrating ssRAB into large hospital settings even if staffed by one interventional pulmonologist.
