A robot-assisted bronchoscope has been shown to improve the diagnosis of small, hard-to-reach lung tumours, according to a randomised controlled trial to be presented at the European Respiratory Society (ERS) Congress in Amsterdam. The study, led by Dr Thomas Gaisl from University Hospital Zürich and presented by Dr Carolin Steinack, evaluated the performance of a robotic-assisted bronchoscopy system equipped with cone-beam CT (CBCT) imaging. The technology enables doctors to navigate deep into the lungs and perform biopsies on small tumours that are inaccessible with conventional bronchoscopes.
The trial involved 78 patients with 127 peripheral lung nodules averaging 11 millimetres in diameter, most of which lacked a connecting airway. Participants were randomly assigned to undergo either the robot-assisted procedure or conventional bronchoscopy guided by X-ray imaging. Using standard bronchoscopy, doctors were able to reach and biopsy 23% of the tumours. The robot-assisted system achieved a success rate of more than 84%. When the robotic technique was used after failed conventional attempts, it enabled successful biopsies in 93% of cases.
Among all patients, 68 were diagnosed with lung cancer, including 50 with stage 1A disease. Dr Steinack said the robotic-assisted method achieved a diagnostic yield more than three times higher than the conventional approach, offering a viable option for patients in whom traditional bronchoscopy is ineffective. The researchers noted that around 20 such robotic systems are currently in use across Europe, with numbers increasing. The equipment costs approximately €1 million, and each procedure adds about €2,000 to the total cost. Dr Gaisl said the technology is most suitable for centres managing large numbers of patients with small, inaccessible lung lesions.
The research team plans to investigate whether the same system could be used to both diagnose and treat tumours in a single session, for example by using radiofrequency or microwave ablation. A related study presented by the same group compared guidance technologies for bronchoscopy and found that the robotic system outperformed both virtual 3D airway models and electromagnetic navigation bronchoscopy.
Photo credit: Steinack & Gaisl / ERS
