Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine/Barnes Jewish Hospital, St. Louis, Missouri.
Division of Pulmonary and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Ann Thorac Surg. 2018 Jul;106(1):293-297. doi: 10.1016/j.athoracsur.2018.01.051. Epub 2018 Feb 24.
Bronchoscopy for peripheral pulmonary lesions continues to present challenges to clinicians. One potential limitation may be the inability to advance conventional bronchoscopes into close proximity of peripheral lesions before biopsy. This study was performed to assess the reach of a robotic endoscopic system within human cadaveric lungs compared with conventional thin bronchoscopes.
All segmental bronchi (RB1 to 10, LB1 to 10) were accessed in two human cadavers using a conventional thin bronchoscope and robotic endoscope of identical outer diameter. Bronchus generation count and insertion depth measured by electromagnetic navigation and external fluoroscopy were recorded.
The robotic endoscope was advanced beyond the conventional thin bronchoscope in all segments, particularly in bronchi with increased angulation such as RB1 (mean generation count 8 versus 3.5, respectively) and LB1+2 (mean generation count 8 versus 4.5).
The robotic endoscopic system was advanced beyond a conventional thin bronchoscope with identical outer diameter into the periphery of human cadaveric lungs. Improved reach within the lung periphery may address some limitations with contemporary bronchoscopic approaches for peripheral lesion biopsy.
对于外周性肺部病变，支气管镜检查仍然给临床医生带来挑战。一个潜在的局限性可能是在进行活检之前，无法将传统的支气管镜推进到接近外周病变的位置。本研究旨在评估与传统的细支气管镜相比，机器人内镜系统在人体尸体肺部中的可达范围。
使用传统的细支气管镜和外径相同的机器人内镜，对两个人体尸体的所有节段性支气管（RB1 到 10，LB1 到 10）进行了检查。记录电磁导航和外部荧光透视测量的支气管生成计数和插入深度。
在所有节段，机器人内镜都比传统的细支气管镜推进得更远，特别是在角度增加的支气管中，如 RB1（平均生成计数分别为 8 和 3.5）和 LB1+2（平均生成计数分别为 8 和 4.5）。
外径相同的机器人内镜系统比传统的细支气管镜更能推进到人体尸体肺部的外周。在肺外周的可达范围的改善可能会解决当前支气管镜检查方法在进行外周性病变活检时的一些局限性。
