Bronchoscopy is a procedure commonly used to diagnose lung cancer and other lung diseases by biopsying lung nodules. Traditional bronchoscopy involves a doctor manually guiding a thin tube, known as a bronchoscope, through the patient's mouth or nose, past the vocal cords and windpipe, and into the lungs' passageways. The bronchoscope contains a light, camera, and biopsy tools that enable doctors to visually examine and biopsy nodules. Robotic bronchoscopy, also known as robotic-assisted bronchoscopy, is a recent advancement in bronchoscopy that allows doctors to examine and collect tissue samples from the hard-to-reach periphery of the lungs.

At Yale Medicine (New Haven, CT, USA), highly trained interventional pulmonologists and thoracic surgeons perform robotic bronchoscopy using the most up-to-date techniques. Robotic bronchoscopy, like traditional bronchoscopy, is a minimally invasive approach that enables doctors to biopsy nodules in the lungs. However, the robotic bronchoscopy procedure is different as a controller at a console is used by the doctor to operate a robotic arm that guides a catheter - a thin, flexible, and maneuverable tube fitted with a camera, light, and shape-sensing technology - through a patient's airways.

Those who will benefit from robotic bronchoscopy will have CT scans of their chest done before the procedure. These scans allow doctors to locate nodules within the airway. The robotic bronchoscopy system then produces a virtual three-dimensional (3D) image of the lungs and the airways within the lungs from the CT scans. The system’s planning software creates virtual pathways through the airways to nodules in the lungs. During the procedure, doctors guide the robotic bronchoscope through airways alongside these virtual pathways to examine and biopsy nodules. The robotic arm’s precise movements enable doctors to accurately direct the catheter around tight turns in the airways and into the hard-to-reach areas of the lungs. This means doctors can examine and biopsy suspicious nodules - and potentially detect cancer - in parts of the lungs that may be inaccessible with traditional bronchoscopy. What’s more, the procedure is safe - serious complications are rare - and recovery is usually quick.

Individuals suited for robotic bronchoscopy undergo chest CT scans prior to the procedure. These scans enable doctors to identify nodules present in the airway. A virtual 3D image of the lungs and airways inside them is then generated using a robotic bronchoscopy system from the CT scans. The planning software of the system creates virtual pathways through the lung's airways to reach the nodules. During the procedure, doctors use these pathways to guide the robotic bronchoscope through the airways to examine and biopsy the nodules. The precise movements of the robotic arm allow physicians to steer the catheter around tight turns in the airways and reach the difficult-to-reach regions of the lungs. This allows healthcare providers to check for biopsy suspicious nodules and identify cancer in areas of the lungs that may be impossible to access using traditional bronchoscopy. Importantly, the robotic bronchoscopy procedure is safe, with rare serious complications and usually quick recovery times.

“Our highly trained interventional pulmonologists and thoracic surgeons will be performing robotic bronchoscopy at Yale,” said Yale Medicine interventional pulmonologist Sanket Thakore, MD. “They make lung cancer diagnosis and management the main focus of their practice. Additionally, they are on the cutting edge and use the most up-to-date techniques and technology to provide the highest level of care to their patients. For lung cancer patients, they work closely with other experts in the Thoracic Oncology Program to provide the best treatments and outcomes.”

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