Paez, Rafael, Lentz, Robert James, Duke, Jennifer D., Siemann, Justin K., Salmon, Cristina, Dahlberg, Greta Jean, Ratwani, Ankush P., Casey, Jonathan Dale, Chen, Heidi C., & Chen, Sheauchiann. (2025). Robotic versus electromagnetic bronchoscopy for peripheral pulmonary lesions: A randomized trial (RELIANT).American Journal of Respiratory and Critical Care Medicine, 211(9). https://doi.org/10.1164/rccm.202409-1846OC
Robotic-assisted bronchoscopy is a newer method for taking tissue samples from hard-to-reach areas of the lungs, offering an alternative to the more established electromagnetic navigational bronchoscopy. Although both techniques are commonly used, there is limited data comparing their effectiveness.
In this study, we conducted a single-center, cluster-randomized trial where patients scheduled for biopsy of a peripheral lung lesion were assigned to either robotic-assisted or electromagnetic navigational bronchoscopy, with the operating room serving as the unit of randomization. The main goal was to see how often each procedure successfully obtained tissue from the lung lesion. Secondary outcomes included procedure time and complications.
Among 411 patients analyzed, robotic-assisted bronchoscopy successfully collected tissue in 77.8% of cases, compared with 75.5% for electromagnetic navigation, showing that robotic-assisted bronchoscopy was at least as effective. The procedure took a median of 37 minutes for robotic-assisted versus 32 minutes for electromagnetic navigation. Pneumothorax, a known complication, occurred in 4 patients in the robotic group and 6 in the electromagnetic group.
Overall, robotic-assisted bronchoscopy is similarly effective and safe as electromagnetic navigation for evaluating peripheral lung lesions.
Figure 1.Consort Diagram. ENB = electromagnetic navigational bronchoscopy; RAB = robotic-assisted bronchoscopy.