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We are aware of unpublished experiences using RB in teenagers and cone-beam CT guided bronchoscopy in younger children.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.