ORIGINAL RESEARCH article
Front. Surg.
Sec. Thoracic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1641868
Robotic-assisted Bronchoscopic Localization for Small Pulmonary Nodules: A Novel Approach to Minimally Invasive Surgery
Provisionally accepted
- China-Japan Friendship Hospital, Beijing, China
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Background: Precise intraoperative localization of small pulmonary nodules is crucial for minimally invasive lung surgery. Robotic bronchoscopy, combining electromagnetic navigation and fluorescence marking, addresses limitations of traditional methods. Methods: This feasibility study included 10 patients (mean age 58) with ground-glass/partially solid nodules (mean diameter 1.42 cm). Using the Monarch® robotic system, nodules were intraoperatively marked with fluorescent dye (indocyanine green/methylene blue). Segmentectomy (4) or wedge resection (6) was performed, with lobectomy added if needed. Results: All nodules were successfully localized (mean time 16.9 minutes) without complications. Resected specimens confirmed central nodule placement. Pathology identified primary lung cancer in all cases: 1 adenocarcinoma in situ, 3 microinvasive, and 6 invasive. Lobectomy was avoided in 4 segmentectomy cases but required in 5/6 wedge resections. Conclusion: Robotic bronchoscopic localization enables safe, precise intraoperative marking, minimizing healthy tissue resection. This pilot study supports its clinical potential, warranting larger trials for validation.
Keywords: Robotic bronchoscopy, pulmonary nodules, Intraoperative localization, Lung segmentectomy, lung cancer
Received: 05 Jun 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Yu, Yang, Chen, Kong, Zhang, Tian, Zhang and Liang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhenrong Zhang, China-Japan Friendship Hospital, Beijing, China
Chaoyang Liang, China-Japan Friendship Hospital, Beijing, China
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