Cancer is well-known for its high mortality rate and rising global incidence. Lung cancer is particularly devastating and was the second most common cancer worldwide in 2020, according to the World Cancer Research Fund International. Over 2.2 million new cases and 1.8 million deaths were reported that year. However, like other cancers, lung cancer is more treatable if detected early.

Researchers at the Beijing Institute of Technology (Beijing, China) have developed an innovative robotic bronchoscope system that non-invasively accesses lung areas for minimally invasive pulmonary lesion sampling, the gold standard for lung cancer diagnosis. To accurately target the lesion of interest, the end effector's position and pose must be determined in real-time. The researchers tackled this issue by creating a navigation system that attaches an endoscope and two electromagnetic sensors to the end effector, enabling online positioning for navigation and supplying visual information for doctors to diagnose and sample.

The navigation system also constructs a three-dimensional virtual model based on computed tomography for robotic path planning, allowing for the selection of the target area. By combining the flexible end effector with the navigation system, the robotic bronchoscope system can automatically reach the target lesion and offer intraoperative visual guidance for biopsy sampling. The researchers verified the feasibility of the robotic bronchoscope system through an ex vivo navigation-assisted intervention experiment. The position displayed by the virtual endoscope's third perspective matched the end effector's tip position relative to the airway phantom, as observed visually. The virtual endoscope view also matched the real video captured by the endoscope module, as anticipated by the researchers. Going forward, the researchers plan to reduce the end effector's diameter, adopt replaceable modules for various surgical needs, explore joint control for more flexible robot movement in the airway, and implement computer vision algorithms for automatic and intelligent calibration.

“Imagine inserting a long thin line into your mouth, through your airway to cut a little part of the lesion of interest within your lung. After that, this thin line brings the cut sample back for further examination to determine whether it’s benign or malignant,” said the researchers, “This is what the bronchoscope system was designed for.” 

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