From May 22nd to 24th, 2026, the 19th Bronchoscopy Symposium and Respiratory Interventional Diagnosis and Treatment Technology Training Course, hosted by the Beijing Society of Integrative Medicine and organized by the Emergency General Hospital, was successfully held at the Yuyang Hotel in Beijing. This conference focused on technological advancements and clinical practices in the field of respiratory intervention, bringing together numerous renowned experts from home and abroad. As a key participating company, Puli Ark specially invited Professor Joseph Cicenia, MD, Director of the Bronchoscopy Center at the Cleveland Clinic, to give a keynote speech at the conference and showcase the cutting-edge applications of the Puli Baichuan (Galaxy) bronchoscopy robot.

International Perspective: Current Status of Robotic Bronchoscopy in the United States

On the morning of May 23, following the session on "The Current Status and Challenges of Interventional Pulmonology," Professor Joseph Cicenia was invited to give a presentation entitled "The Current Status of Robotic Bronchoscopy in the United States," systematically introducing the latest developments in the field of robot-assisted bronchoscopy in the United States. Professor Cicenia first reviewed the long-standing technical bottlenecks of traditional navigation bronchoscopy in terms of positioning accuracy, image guidance capabilities, and tool stability. He pointed out that the lack of shape-sensing technology for real-time imaging still limits the "CT-to-body divergence," making it difficult to solve the core problem of inaccurate positioning.

Innovative solutions from the Galaxy system

“So, how do we address the long-standing challenge of CT-to-body divergence?” Professor Cicenia shifted the focus, showcasing the innovative solution of the Galaxy bronchoscopy robot to the attendees. He explained that the Galaxy system deeply integrates 3D Imaging DT technology, which uses Digital Tomosynthesis (DT) imaging as its core. This technology can update the lesion location in real time during surgery and confirm whether the biopsy tool is truly within the lesion—a process we call Tool-in-Lesion (TIL) confirmation. This technology bridges the gap between preoperative static CT scans and the actual intraoperative anatomical structures, allowing surgeons to “see clearly and accurately” during the procedure.

Professor Cicenia cited key clinical study data: In the MATCH 2 study, the Galaxy system equipped with this technology achieved a TIL confirmation rate of 93.5% in 31 nodules[1], with a consistency rate of 96.7% with CBCT confirmation results[1], and a navigation and biopsy success rate of 100%[1]. This fully verifies the reliability of the system in real-time lesion localization.

He further pointed out that the Galaxy system also integrates Augmented Fluoroscopy (AF) functionality. Even if a lesion cannot be visualized under conventional 2D fluoroscopy, AF can overlay the lesion's location onto the image in real time, providing doctors with visual guidance. In addition, the system's distance quantification function can quantitatively measure the actual distance between the biopsy tool and the center of the lesion, helping doctors determine in three-dimensional space whether the tool is truly located within the lesion, avoiding sampling errors that can lead to significant discrepancies.

Professor Cicenia summarized, "Our experience using the Galaxy system at my Cleveland Clinic demonstrates that the organic combination of endoscope stability, navigation success rate, and real-time image guidance is key to accurate lung nodule biopsies." The Galaxy system achieves a technological leap from 'navigation-accessible' to 'intraoperative real-time confirmation' by deeply integrating digital tomography, enhanced fluoroscopy, and real-time navigation technology, providing a practical solution for the diagnosis of small peripheral lung nodules.

Galaxy Bronchoscope Robot

Conference Summary and Outlook

This symposium not only provided a high-level learning and exchange platform for domestic interventional pulmonologists, but also demonstrated Puli Ark's proactive role in promoting international academic cooperation and innovation in domestically produced medical equipment. In the future, our company will continue to dedicate itself to technological research and development and clinical application in the field of interventional pulmonology, working hand in hand with domestic and international experts to jointly promote the high-quality development of interventional pulmonology in China.

He specifically introduced the integrated image-guided capabilities of the Galaxy system, including Digital Tomosynthesis (DT) and Augmented Fluoroscopy (AF), which enables real-time "tool-lesion" confirmation during surgery, significantly improving diagnostic accuracy. Professor Cicenia also shared data from several clinical studies, including the FRONTIER, MATCH 2, and ORBIT studies, showing that the system achieves a positive diagnostic rate of 87.7%-96.7% for lesions with an average diameter of approximately 16-21 mm, and also demonstrates good application potential in sub-centimeter nodules.

Pulibaichuan Bronchoscope Robot: Domestic Innovation and Internationalization Go Hand in Hand

During the conference, the Puli Ark booth showcased the Puli Baichuan bronchoscopy robot system, attracting the attention of many attending experts. This system integrates electromagnetic navigation, digital tomography, and enhanced fluoroscopy technologies, possessing core functions such as intraoperative target location updates and tool-lesion confirmation. The system has a small footprint (6.3 square feet), is compatible with most 2D C-arm, mobile, and fixed CBCT scanners, and has strong clinical adaptability.

In her report, Professor Cicenia also compared the Noah Galaxy system with existing mainstream platforms (such as Ion and Monarch), pointing out its advantages in image integration, intraoperative confirmation, and ease of operation, which further enhanced the participants' confidence in the domestically produced robotic bronchoscopy platform.

Conference Summary and Outlook

This symposium not only provided a high-level learning and exchange platform for domestic interventional pulmonologists, but also demonstrated Puli Ark's proactive role in promoting international academic cooperation and innovation in domestically produced medical equipment. In the future, our company will continue to dedicate itself to technological research and development and clinical application in the field of interventional pulmonology, working hand in hand with domestic and international experts to jointly promote the high-quality development of interventional pulmonology in China.

The Cleveland Clinic's experience using the Noah Galaxy system demonstrates its advantages:

High diagnostic rate

• Short operation time

• Reduce healthcare costs

3D Imaging (DT) technology, based on Digital Tomosynthesis (DT) imaging, has been deeply integrated with the Pribain system. This proprietary core technology can update the lesion location in real time during surgery and confirm that the tool is within the lesion (Tool-in-Lesion, TIL), effectively reducing the deviation between preoperative CT and actual anatomical structures, thereby improving localization accuracy and diagnostic success rate.

【1】Mahajan AK, Duong DK, Cortes J, Bhadra K. The match 2 study: Robotic assisted bronchoscopy with integrated imaging with assessment of digital tomosynthesis (DT) and augmented fluoroscopy (AF): Three-Dimensional accuracy as confirmed by cone beam computed tomography (CBCT). Respir Med. 2026 Mar;253:108693. doi: 10.1016/j.rmed.2026.108693. Epub 2026 Jan 29. PMID: 41620189.