A Review of Flexible Bronchoscope Robots for Peripheral Pulmonary Nodule Intervention

The development of procedure-specific surgical robots has become essential for tackling complex clinical challenges. Flexible bronchoscope robots (FBRs) have emerged over the past decade, revealing broad prospects for the safe, precise, and reliable diagnosis of peripheral pulmonary nodules (PPNs), which is crucial for enabling early lung cancer treatment. However, in advancing FBR development, roboticists sometimes stray from or overlook practical surgical considerations, which might impede its clinical implementation. This review aims to bridge this gap by offering an engineering-focused perspective enriched with critical medical insights to drive the clinical translation of next-generation FBRs. We begin by highlighting the medical significance and current state of FBR research. Then, we outline the “ambient environments” of FBRs: the supported procedure, robotic system, steering tools, and deployment modes. Subsequently, we summarize recent progress in FBR technology, focusing on two key areas: procedure-specific design and modeling to improve intervention capabilities, and autonomous navigation and control strategies to enhance autonomy. Based on the given analysis, we discuss the development directions of next-generation FBRs according to the current clinical challenges and the engineering approaches to their realization.