C23-17 Navigational Performance: Comparing Robotic and Conventional Bronchoscopy in Novice Pulmonary Trainees

Abstract Rationale Over the past several years, the rapid adoption of robotic-assisted bronchoscopy (RAB) has transformed not only the approach to clinical diagnosis but also the educational experience of pulmonary trainees. Since 2018, RAB has become an integral component of Pulmonary and Critical Care Medicine fellowship training, offering enhanced precision and access to peripheral pulmonary lesions. As exposure to this technology expands, it presents a unique opportunity to evaluate how trainees acquire bronchoscopy skills in a technologically advanced environment. Given the intuitive interface and digital dexterity afforded by the Ion by Intuitive RAB system—particularly among a generation of trainees accustomed to virtual platforms—we hypothesize that individuals with no prior bronchoscopy experience will demonstrate superior performance on an Ion simulator compared to traditional systems. Methods Ten first-year PCCM fellows participated during orientation prior to clinical rotations. Each completed three simulations using the Ion RAB simulator and a conventional Olympus P-190 bronchoscope, navigating to targets in the left lower lobe, right lower lobe, and right upper lobe of a lung model. Trial sequence was fixed, and participants were randomized to start with either system. Metrics included (1) wall contacts, (2) time to target, and (3) completion within two minutes. Results Participants averaged 3.47 wall contacts on conventional bronchoscopy and 4.67 on the Ion simulator. Average times were 83 seconds for conventional bronchoscopy with a 70% completion rate, and 73.3 seconds for RAB with an 80% completion rate. Overall, robotic bronchoscopy showed slightly more wall contacts but faster procedure times, and a higher completion rate of 80% compared to 70% on conventional bronchoscopy. Discussion These findings suggest that robotic-assisted bronchoscopy (RAB) may offer a technical advantage for trainees with limited bronchoscopy experience. Despite slightly higher wall contact rates, participants achieved faster navigation times and higher completion rates using the Ion system compared to conventional bronchoscopy. Increased wall contacts likely reflect a speed-accuracy trade-off, with trainees prioritizing faster navigation over minor collisions. This highlights the maneuverability of the robotic platform. High completion rates across all lobes demonstrate RAB’s ability to facilitate scope manipulation. Familiarity with technology among current fellows may enhance adaptability to robotic systems, contributing to improved simulator performance. RAB may thus serve as an effective tool to accelerate skill acquisition and confidence, complementing traditional bronchoscopy training. Development of future bronchoscopy modalities should take into account the virtual dexterity of a younger generation of future pulmonologists. This abstract is funded by: None