To the Editor,
Robotic bronchoscopy (RB) is becoming a preferred method for sampling
peripheral pulmonary lesions in adults. RB allows preparation for the
procedure using a planning software and provides direct visualization of
the airways while simultaneously controlling the location of the scope
assisted by a virtual 3-D reconstruction. Accuracy of navigation is
verified with fluoroscopy and/or radial probe ultrasound (rEBUS) during
the procedure (1). In adults, there is growing evidence that RB can
increase diagnostic yield while minimizing complications (2).
Alternative methods include percutaneous CT guided biopsy which lacks
the ability to biopsy multiple lesions and carries a higher risk of
complications, as well as conventional bronchoscopy which is often
unable to maneuver into more peripheral lesions. Published data for RB
report a diagnostic yield of 69 – 88% and a 0 - 3.8% rate of
pneumothorax (3).
We are aware of unpublished experiences using RB in teenagers and
cone-beam CT guided bronchoscopy in younger children. There is
minimal-to-no published data of the use of RB in the latter group. As
one of the available platforms utilizes a scope with a 3.5 mm outer
diameter (OD) it could be used in small children. Here, we present a
case demonstrating the utility of RB in a 5-year-old with peripheral
pulmonary lesions.