Accuracy of a Robotic Endoscopic System in Cadaver Models with Simulated Tumor Targets: ACCESS Study.

Autor:	Chen AC; Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St. Louis, Missouri, USA, chenac@wustl.edu., Pastis NJ; Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA., Machuzak MS; Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA., Gildea TR; Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA., Simoff MJ; Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Wayne State University School of Medicine, Detroit, Michigan, USA., Gillespie CT; Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA., Mahajan AK; Inova Heart and Vascular Institute, Falls Church, Virginia, USA., Oh SS; Division of Pulmonary Medicine, University of California, Los Angeles, California, USA., Silvestri GA; Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Jazyk:	angličtina
Zdroj:	Respiration; international review of thoracic diseases [Respiration] 2020; Vol. 99 (1), pp. 56-61. Date of Electronic Publication: 2019 Dec 05.
DOI:	10.1159/000504181
Abstrakt:	Background: Bronchoscopy for the diagnosis of peripheral pulmonary lesions continues to present clinical challenges, despite increasing experience using newer guided techniques. Robotic bronchoscopic platforms have been developed to potentially improve diagnostic yields. Previous studies in cadaver models have demonstrated increased reach into the lung periphery using robotic systems compared to similarly sized conventional bronchoscopes, although the clinical impact of additional reach is unclear. Objectives: This study was performed to evaluate the performance of a robotic bronchoscopic system's ability to reach and access artificial tumor targets simulating peripheral nodules in human cadaveric lungs. Methods: Artificial tumor targets sized 10-30 mm in axial diameter were implanted into 8 human cadavers. CT scans were performed prior to procedures and all cadavers were intubated and mechanically ventilated. Electromagnetic navigation, radial probe endobronchial ultrasound, and fluoroscopy were used for all procedures. Robotic-assisted bronchoscopy was performed on each cadaver by an individual bronchoscopist to localize and biopsy peripheral lesions. Results: Sixty-seven nodules were evaluated in 8 cadavers. The mean nodule size was 20.4 mm. The overall diagnostic yield was 65/67 (97%) and there was no statistical difference in diagnostic yield for lesions <20 mm compared with lesions measuring 21-30 mm, the presence of a concentric or eccentric radial ultrasound image, or relative distance from the pleura. Conclusions: The robotic bronchoscopic system was successful at biopsying 97% of peripheral pulmonary lesions 10-30 mm in size in human cadavers. These findings support further exploration of this technology in prospective clinical trials in live human subjects. (© 2019 S. Karger AG, Basel.)
Databáze:	MEDLINE
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