From May 22nd to 24th, 2026, the 19th Bronchoscopy Symposium and Respiratory Interventional Diagnosis and Treatment Technology Training Course, hosted by the Beijing Society of Integrative Medicine and organized by the Emergency General Hospital, was successfully held at the Yuyang Hotel in Beijing. This conference focused on new technological advancements and clinical practices in the field of respiratory intervention, bringing together numerous renowned experts from home and abroad. As a key participating company, Puli Ark specially invited Professor Joseph Cicenia, MD, Director of the Bronchoscopy Center at the Cleveland Clinic, to give a keynote speech at the conference and showcase the cutting-edge applications of the Puli Baichuan (Galaxy) bronchoscopy robot.

International Perspective: Current Status of Robotic Bronchoscopy in the United States

On the morning of May 23, following the session on "The Current Status and Challenges of Interventional Pulmonology," Professor Joseph Cicenia was invited to give a presentation entitled "The Current Status of Robotic Bronchoscopy in the United States," systematically introducing the latest developments in the field of robot-assisted bronchoscopy in the United States. Professor Cicenia first reviewed the long-standing technical bottlenecks of traditional navigation bronchoscopy in terms of positioning accuracy, image guidance capabilities, and tool stability. He pointed out that the lack of shape-sensing technology for real-time imaging still limits the "CT-to-body divergence," making it difficult to solve the core problem of inaccurate positioning.

Innovative solutions from the Galaxy system

“So, how do we address the long-standing challenge of CT-to-body divergence?” Professor Joseph Cicenia shifted his focus, showcasing the innovative solution of the Galaxy bronchoscopy robot to the attendees. He explained that the Galaxy system deeply integrates 3D Imaging DT technology, which uses Digital Tomosynthesis (DT) imaging as its core. This technology can update the lesion location in real time during surgery and confirm whether the biopsy tool is truly located within the lesion—a process we call Tool-in-Lesion (TIL) confirmation. This technology compensates for the discrepancy between preoperative static CT and the actual intraoperative anatomical structure, allowing doctors to “see clearly and accurately” during the procedure.

Professor Joseph Cicenia cited key clinical study data: In the MATCH 2 study, the Galaxy system equipped with this technology achieved a TIL confirmation rate of 93.5% in 31 nodules[1], with a consistency rate of 96.7% with CBCT confirmation results[1], and a navigation and biopsy success rate of 100%[1]. This fully verifies the reliability of the system in real-time lesion localization.

He further pointed out that the Galaxy system also integrates Augmented Fluoroscopy (AF) functionality. Even if a lesion cannot be visualized under conventional 2D fluoroscopy, AF can overlay the lesion's location onto the image in real time, providing doctors with visual guidance. In addition, the system's distance quantification function can quantitatively measure the actual distance between the biopsy tool and the center of the lesion, helping doctors determine in three-dimensional space whether the tool is truly located within the lesion, avoiding sampling errors that can lead to significant discrepancies.

Professor Cicenia summarized, "Our experience using the Galaxy system at my Cleveland Clinic demonstrates that the organic combination of endoscope stability, navigation success rate, and real-time image guidance is key to accurate lung nodule biopsies." The Galaxy system achieves a technological leap from 'navigation-accessible' to 'intraoperative real-time confirmation' by deeply integrating digital tomography, enhanced fluoroscopy, and real-time navigation technology, providing a practical solution for the diagnosis of small peripheral lung nodules.

Galaxy Bronchoscope Robot

Conference Summary and Outlook

This symposium not only provided a high-level learning and exchange platform for domestic interventional pulmonologists, but also demonstrated Puli Ark's proactive role in promoting international academic cooperation and innovation in domestically produced medical equipment. Moving forward, Puli Ark will continue to dedicate itself to technological research and development and clinical application in the field of interventional pulmonology, working hand in hand with experts from home and abroad to jointly promote the high-quality development of interventional pulmonology in China.

References:

【1】Mahajan AK, Duong DK, Cortes J, Bhadra K. The match 2 study: Robotic assisted bronchoscopy with integrated imaging with assessment of digital tomosynthesis (DT) and augmented fluoroscopy (AF): Three-Dimensional accuracy as confirmed by cone beam computed tomography (CBCT). Respir Med. 2026 Mar;253:108693. doi: 10.1016/j.rmed.2026.108693. Epub 2026 Jan 29. PMID: 41620189.

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