{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:57:25Z","timestamp":1790600245135,"version":"4.1.0"},"reference-count":79,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The evaluation of peripheral pulmonary lesions (PPLs) is a persistent clinical challenge, made more pressing by the expansion of low-dose CT lung cancer screening. Conventional and earlier navigational bronchoscopy, including electromagnetic navigation, historically achieved diagnostic yields of approximately 60\u201370%, with CT-to-body divergence contributing to nondiagnostic sampling. This narrative review, prepared using the Scale for the Assessment of Narrative Review Articles (SANRA), summarizes robotic-assisted bronchoscopy (RAB) platform technology, procedural optimization, diagnostic performance, safety, molecular tissue adequacy, and emerging applications. A structured search was updated through September 2026; this is not a systematic review. Using the strict definition recommended by the American Thoracic Society\/American College of Chest Physicians (ATS\/ACCP), the most comprehensive meta-analysis reported a pooled RAB diagnostic yield of 69.6%, while the prospective multicenter TARGET study reported an adjudicated strict yield of 61.6%. Higher pooled estimates of approximately 84\u201387% generally use intermediate definitions that the ATS\/ACCP statement recommends against as primary diagnostic-yield measures. RAB pneumothorax rates are approximately 2% in pooled analyses, compared with approximately 20\u201325% for CT-guided transthoracic needle biopsy. In the randomized RELIANT trial, RAB was non-inferior, but not superior, to electromagnetic navigation bronchoscopy; in VERITAS, navigational bronchoscopy as a category was non-inferior to transthoracic needle biopsy for 12-month diagnostic accuracy, with fewer pneumothoraces. RAB is a useful option for selected PPLs, but strict-definition performance is more modest than frequently quoted intermediate yields. Outcomes depend on lesion characteristics, sampling strategy, operator experience, center volume, and imaging infrastructure.<\/jats:p>","DOI":"10.3390\/diagnostics16193151","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:35:59Z","timestamp":1790595359000},"page":"3151","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Robotic-Assisted Bronchoscopy for Peripheral Pulmonary Lesions: Current Evidence, Clinical Applications, and Future Directions"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8322-4824","authenticated-orcid":false,"given":"Venkatkiran","family":"Kanchustambham","sequence":"first","affiliation":[{"name":"Interventional Pulmonology and Cystic Fibrosis Program, Sanford Health, Fargo, ND 58102, USA"},{"name":"Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"U.S. Preventive Services Task Force (2021). 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