Supplementary Material for: Robotic-Assisted Bronchoscopy Integrated with 3D-Fluoroscopy for Sampling Bilateral Pulmonary Nodules in a Single Procedure

Bronchoscopic biopsy of peripheral pulmonary nodules has evolved in recent years with the emergence of new technologies such as shape-sensing robotic-assisted bronchoscopy. The use of three-dimensional (3D) fluoroscopy for intraoperative visualization of the biopsy tool in relation to the target nodule aims to overcome computed tomography-to-body divergence encountered during the procedure and allows for more accurate sampling to improve adequacy and diagnostic performance. Until now, the robotic-assisted navigation plan and 3D transprocedural imaging function as separate systems. We present a case where intraoperative 3D fluoroscopy images were integrated to the robotic bronchoscopy navigation system, resulting in a single, dynamic, real-time 3D virtual plan showing readjusted paths towards the lesion displayed in the robotic bronchoscopy navigation system, allowing in this case, biopsying two bilateral pulmonary nodules resulting in different diagnosis within the same anesthetic procedure.

近年来，随着形状感应机器人辅助支气管镜（shape-sensing robotic-assisted bronchoscopy）等新兴技术的问世，肺外周结节的支气管镜活检技术迎来了新的发展。术中借助三维（3D）荧光透视可视化活检工具与目标结节的相对位置，旨在克服手术过程中CT影像与实际人体解剖结构间存在的偏差，实现更精准的组织采样，进而提升标本合格率与诊断效能。截至目前，机器人辅助导航计划与三维术中成像功能仍为两套独立运行的系统。本次报告呈现一则病例：术中三维荧光透视图像被集成至机器人支气管镜导航系统中，由此生成一套单一、动态的实时三维虚拟规划方案，可在机器人支气管镜导航系统中展示针对病变病灶的调整后操作路径；本例中，该方案得以在同一麻醉流程下完成双侧两枚肺结节的活检，并获得了不同的病理诊断结果。