Abstract / Summary
Pulmonary nodules are commonly evaluated using the CT-guided transthoracic biopsy; however, it is highly dependent on operator skill and can be associated with extended procedure duration and increased radiation exposure. Although robotic-assisted systems are intended to enhance procedural precision, there is limited comparative evidence against conventional techniques. Accordingly, this systematic review and meta‑analysis was conducted to compare robotic-assisted biopsy with conventional CT-guided transthoracic biopsy. We systematically searched Scopus, Web of Science, PubMed, CNKI, and the Cochrane Library until February 2026. Both randomized trials and cohort studies comparing robotic and conventional (manual) CT-guided transthoracic needle biopsy in adults were included in this review. The outcomes included procedural efficiency, diagnostic performance, radiation exposure, and safety. Meta-analysis was conducted using RevMan 5.4.1, presenting MD, RR, or OR with 95% CIs. Heterogeneity and publication bias were assessed. Nine studies were included. Compared with conventional (manual) CT-guided biopsy, the robotic approach was associated with shorter procedure time (MD = -4.94, 95% CI [-9.56, -0.32], P = 0.04) and lower radiation exposure (DLP) (MD = -211.55, 95% CI [-305.07, -118.03], P < 0.00001). Additionally, the robotic approach reduced the number of needle adjustments required, pneumothorax incidence, and overall complication incidence (RR = 0.460, 95% CI [0.290, 0.720], P = 0.0008). A reduction in the number of CT scans was observed only in the sensitivity analysis. Technical success, diagnostic yield, pulmonary hemorrhage, and chest tube placement were similar between the robotic-assisted and conventional techniques. Robot-assisted CT-guided biopsy was associated with lower radiation exposure, reduced procedural complexity, and fewer complications while maintaining comparable technical success and diagnostic yield. However, these findings should be interpreted cautiously, given the limited number of included studies, substantial heterogeneity, and observational nature of much of the available evidence. Further large prospective studies are required to validate these findings.
Primary Source
Journal of robotic surgery
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