Robotic assisted bronchoscopy has emerged as an alternative to electromagnetic navigational bronchoscopy for patients undergoing bronchoscopic biopsy of a peripheral pulmonary lesion. While both platforms are routinely used in clinical practice, comparative effectiveness data are lacking.
To compare the effectiveness of robotic assisted and electromagnetic navigational bronchoscopy for evaluation of peripheral pulmonary lesions.
In an investigator-initiated, single-center, cluster randomized noninferiority trial, we assigned patients undergoing diagnostic bronchoscopy for evaluation of a peripheral pulmonary lesion to either robotic assisted or electromagnetic navigational bronchoscopy. The cluster randomization unit was the operating room in which patients were scheduled. The primary outcome was the diagnostic yield of the procedure, defined as the proportion of cases yielding lesional tissue. Secondary and safety outcomes included procedure duration and complications.
Among the 411 patients included in the modified intention to treat analysis, lesional tissue was obtained in 158 of 203 (77.8%) patients in the robotic assisted group and 157 of 208 (75.5%) patients in the electromagnetic group, p-value for non-inferiority 0.007. The median duration of bronchoscopy was 37 minutes in the robotic assisted group and 32 minutes in the electromagnetic group (difference, 5 minutes; 95% confidence interval 2.0 to 7.7). Pneumothorax occurred in 4 patients in the robotic assisted group and 6 patients in the electromagnetic group.
In patients undergoing bronchoscopy for the evaluation of a peripheral pulmonary lesion, the diagnostic yield of robotic assisted bronchoscopy was not inferior to that of electromagnetic navigation bronchoscopy. Clinical trial registration available at www.
gov, ID: NCT05705544. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
This research output has an Altmetric Attention Score of 19. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 February 2026.
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