Robotic and navigational bronchoscopy

Robotic and navigational bronchoscopy steers an ultrathin, robotically articulated catheter along a CT-derived airway map to a lung nodule, with radial endobronchial ultrasound or cone-beam CT confirming position before biopsy. The Intuitive Ion and Johnson & Johnson Monarch platforms combine electromagnetic or shape-sensing navigation with cone-beam CT to sample peripheral nodules found by screening, avoiding a needle through the chest wall. Diagnostic yield is about 80 to 90% with low pneumothorax rates, and the tissue is usually enough for molecular testing on small lesions. Yield still depends on the bronchus sign and operator, and the platforms are costly, so the comparison with CT-guided needle biopsy is not settled. It is increasingly paired with same-session ablation trials. In plain terms, it is a robot-guided scope that reaches small nodules from inside the lung.