CUHK the first to perform robotic-assisted bronchoscopy in hybrid OT outside the US

Thoracic surgeons from the Chinese University of Hong Kong (CUHK) have become the first to successfully perform robotic-assisted bronchoscopy in a hybrid operating theatre (OT) setting outside the US.

Between early December 2021 and mid-March 2022, the thoracic surgical team from CUHK sampled pulmonary lesions in 18 patients using robotic-assisted bronchoscopy in a hybrid operation room.

“We are very excited to have performed the first hybrid operation room robotic-assisted bronchoscopy in the Asia-Pacific region,” said Professor Calvin Ng of Department of Surgery, CUHK. “We now have a tool to accurately access tiny and hard-to-reach lung nodules with greater precision than before.”

Biopsy of small and peripheral pulmonary lesions for early diagnosis of lung cancer remains challenging due to shortcomings of conventional diagnostic methods. For example, conventional bronchoscopy is limited to tissue sampling from central pulmonary nodules, which may result in false negatives and complications, such as pneumothorax and haemorrhage. With robotic-assisted bronchoscopy, small lesions in the peripheral airways can now be accessed for diagnosis of early-stage lung cancer.

According to Dr Rainbow Lau of Department of Surgery, CUHK, robotic-assisted bronchoscopy is an endoscopic procedure that combines real-time optical imaging with electromagnetic navigation (EMN). In particular, EMN helps guide the bronchoscope in peripheral and distal regions of the lung. With a remote console connected with robotic arms and bronchoscope, users can visualize the complex human airways and navigate towards the target location during the procedure.

“The advanced robotic mechanism … maintains stability while tools are deployed for biopsy, improving [the] accuracy of lesion localization and diagnostic yield [of bronchoscopy],” Lau said.

“The improved diagnostic yield with novel robotic-assisted bronchoscopy will lead to earlier lung cancer diagnosis and fewer repeat procedures at a potentially lower cost compared with conventional bronchoscopy, allowing us to provide better patient experience and clinical outcome,” Ng noted.

To investigate the clinical safety and diagnostic accuracy of the robotic-assisted bronchoscopy platform, the CUHK team is currently collaborating with other researchers in a multicentre clinical trial, with a target enrolment of 1,200 patients with pulmonary lesions worldwide. [https://www.aurishealth.com/about/press-releases/first-monarch-robotic-assisted-bronchoscopy-procedure-performed-outside-the-united-states]

“The technology [ie, robotic-assisted bronchoscopy] has been utilized in the US since 2018, with excellent outcomes,” Ng added. In the past 4 years, the US FDA has approved two robotic-assisted bronchoscopy platforms, including the one used by CUHK. [J Clin Med 2021;10:5678]

Preview of lesion location with real-time optical imaging and electromagnetic navigation