Lung cancer is the leading type of cancer and the leading cause of cancer-related mortality. With increasing patient awareness and recent lung cancer screening trials leading to more lung nodules being found, there is a need for safe and accurate techniques for pulmonary nodule biopsy.
RB is the most recent state-of-the-art localization technique. It utilizes the power of robotics and telescoping design to reach deeper into the lung than conventional methods. This precision comes from articulating catheters and real-time direct vision, together with advanced maneuverability for fine adjustment for precise biopsy in the small, tortuous airways of the lungs. This new platform also provides greater stability with the robotic control, locking in position once target nodule has been reached. Physicians’ hands are then free for other interventions.
Currently, there are two commercially available RB platforms, namely the MonarchTM Platform (Auris Health, Redwood City, CA, USA); and the IonTM Endoluminal System (Intuitive Surgical, Sunnyvale, CA, USA). Similar to ENB, pre-operative high-resolution CT is required to create a virtual map for the RB and guide the instruments through electromagnetic navigation (EMN) (MonarchTM) or shape-sensing technology (IonTM). Radial EBUS, fluoroscopy, and cone-beam CT (CBCT) can also be integrated into the system for more precise localization.
In this presentation, we will review the progression of robotic bronchoscopy (RB), its early results, and future developments.