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      A Novel Robotic Bronchoscope System for Navigation and Biopsy of Pulmonary Lesions

      research-article
      1 , 2 , 1 , 2 , 2 , 2 , 2 , 1 , 2 , * ,
      Cyborg and Bionic Systems
      AAAS

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          Abstract

          Transbronchial biopsy sampling, as a minimally invasive method with relatively low risk, has been proved to be a promising treatment in the field of respiratory surgery. Although several robotic bronchoscopes have been developed, it remains a great challenge to balance size and flexibility, while integrating multisensors to realize navigation during complex airway networks. This paper proposes a novel robotic bronchoscope system composed by end effector with relatively small size, relevant actuation unit, and navigation system with path planning and surgical guidance capability. The main part of the end effector is machined by bidirectional groove on a nickel–titanium tube, which can realize bending, rotation, and translation 3 degrees of freedom. A prototype of the proposed robotic bronchoscope system is designed and fabricated, and its performance is tested through several experiments to verify the stiffness, flexibility, and navigation performance. The results show that the proposed system is with good environment adaptiveness, and it can become a promising biopsy method through natural cavity of the human body.

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          Most cited references33

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Progress and prospects of early detection in lung cancer

            Lung cancer is the leading cause of cancer-related death in the world. It is broadly divided into small cell (SCLC, approx. 15% cases) and non-small cell lung cancer (NSCLC, approx. 85% cases). The main histological subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma, with the presence of specific DNA mutations allowing further molecular stratification. If identified at an early stage, surgical resection of NSCLC offers a favourable prognosis, with published case series reporting 5-year survival rates of up to 70% for small, localized tumours (stage I). However, most patients (approx. 75%) have advanced disease at the time of diagnosis (stage III/IV) and despite significant developments in the oncological management of late stage lung cancer over recent years, survival remains poor. In 2014, the UK Office for National Statistics reported that patients diagnosed with distant metastatic disease (stage IV) had a 1-year survival rate of just 15–19% compared with 81–85% for stage I.
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              Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management.

              The objective of this article is to describe potential complications of percutaneous needle biopsy of the chest, discuss the risk factors associated with the development of complications, and explain how to prevent complications and manage complications when they occur. Pneumothorax and pulmonary hemorrhage are the most common complications of percutaneous needle biopsy of the chest, whereas air embolism and tumor seeding are extremely rare. Attention to biopsy planning and technique and postprocedural care help to prevent or minimize most potential complications.
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                Author and article information

                Journal
                Cyborg Bionic Syst
                Cyborg Bionic Syst
                CBSYSTEMS
                Cyborg and Bionic Systems
                AAAS
                2097-1087
                2692-7632
                15 March 2023
                2023
                2023
                : 4
                : 0013
                Affiliations
                [ 1 ]School of Medical Technology, Beijing Institute of Technology , Beijing 100081, China.
                [ 2 ]School of Mechatronical Engineering, Beijing Institute of Technology , Beijing 100081, China.
                Author notes
                [*] [* ]Address correspondence to: lics@ 123456bit.edu.cn
                Article
                0013
                10.34133/cbsystems.0013
                10026825
                36951809
                4293bad7-29a9-448c-ab81-5b008a92d467
                Copyright @ 2023

                Exclusive Licensee Beijing Institute of Technology Press. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY 4.0).

                History
                : 24 September 2022
                : 05 February 2023
                : 15 March 2023
                Page count
                Figures: 6, Tables: 2, References: 39, Pages: 0
                Categories
                Research Article

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