Robotic Bronchoscopy: From Killian's Tube to ABB Labs

How robotic bronchoscopy grew from Killian's 1897 rigid tube and Ikeda's flexible scope to Monarch, Ion and Galaxy robots, and where ABB lab robots fit in.

INDUSTRIAL ROBOTICS

Chat With Robot

10/8/20265 min read

A small spot on a chest CT scan raises a hard question: is it cancer? The only sure answer is a piece of tissue, and many of these nodules sit deep in the outer lung, out of reach of a normal bronchoscope. Robotic bronchoscopy was built for that job. This post follows the path from the rigid tubes of the 1890s to the flexible scope, then to navigation systems and today's robots from Intuitive, Johnson & Johnson and Noah Medical. The last part looks at ABB robots, which work in the labs and factories around the procedure, away from the patient's bedside.

Doctor in green scrubs and cap holding a bronchoscope eyepiece to his eye beside a ventilated patient
Doctor in green scrubs and cap holding a bronchoscope eyepiece to his eye beside a ventilated patient

A doctor looks through a flexible bronchoscope during a bronchoalveolar lavage on a ventilated patient. Photo: MrArifnajafov / Wikimedia Commons (CC BY-SA 3.0)

How doctors first looked into the lungs with brass tubes and light

The story starts in Freiburg, Germany. In 1897 the laryngologist Gustav Killian passed a rigid tube down a patient's windpipe and pulled a pork bone out of the airway, which is counted as the first bronchoscopy. Rigid bronchoscopes are still used today, under general anaesthesia, to remove objects, open blocked airways and stop bleeding. A straight metal tube has one big limit, though. It can follow only the larger, straight airways and cannot bend into the narrow branches of the upper lobes or the outer lung, where many small tumours grow.

Gloved hands guiding a straight metal bronchoscope into the mouth of a patient lying on an operating table
Gloved hands guiding a straight metal bronchoscope into the mouth of a patient lying on an operating table

A rigid bronchoscopy, the method Gustav Killian began in 1897, performed on a patient under anaesthesia. Photo: JBARRETO / Wikimedia Commons (CC BY 3.0)

In the United States, Chevalier Jackson turned the method into a craft. In 1899 he built a bronchoscope from a thin-walled brass tube with a small electric light at its tip, and he worked through it with forceps and hooks. Over his career he removed more than 2,300 inhaled or swallowed objects, from coins and pins to toys, and the collection is on show at the Mütter Museum in Philadelphia. Before his work, nearly everyone who inhaled a foreign body died of it. His methods turned that into a survival rate of about 98 percent.

Black and white portrait of an older man with glasses, white hair and a dark suit
Black and white portrait of an older man with glasses, white hair and a dark suit

Chevalier Jackson, the Philadelphia laryngologist who removed more than 2,300 objects from airways. Photo: Wellcome Collection via Wikimedia Commons (CC BY 4.0)

The next leap came from Japan. In 1966 Shigeto Ikeda introduced the flexible bronchoscope, developed with Machida Endoscope and Olympus. Glass fibres carried the image along a bendable cable, so doctors could steer the tip into upper lobe branches that rigid tubes never reached. Flexible bronchoscopy could be done with the patient sedated instead of fully asleep, and it became a routine hospital test. The scope still ran out of room in the smallest outer airways, and the doctor still had to estimate where a tiny nodule sat.

Two masked doctors in surgical caps and gowns working a thin flexible scope under a bright lamp
Two masked doctors in surgical caps and gowns working a thin flexible scope under a bright lamp

Two physicians perform a flexible bronchoscopy, 1978. Photo: National Cancer Institute via Wikimedia Commons (public domain)

Robotic bronchoscopy today: catheters, cone beam CT and new hospitals

Navigation systems came first. Software turns a CT scan into a 3D map of the airways and plans a route to the nodule, while a tracked sensor or a camera shows where the catheter tip is. Robots then took over the steering. Auris Health, founded by Frederic Moll, won FDA clearance for its Monarch Platform on 26 March 2018. Intuitive followed on 19 February 2019, when the FDA cleared its Ion endoluminal system for minimally invasive biopsy in the peripheral lung. Both drive a thin catheter that holds its shape while the doctor passes a needle through it.

Black flexible bronchoscope coiled on a white background with its handle and eyepiece
Black flexible bronchoscope coiled on a white background with its handle and eyepiece

A flexible bronchoscope with its control handle and long insertion tube. Photo: Håkon Olav Leira / Wikimedia Commons (CC BY-SA 3.0)

New products keep arriving. On 27 August 2026 Noah Medical said its Galaxy System now works with GE HealthCare's premium OEC C-arms, including the OEC 3D mobile cone beam CT, through its Galaxy II software. With 3D imaging in the room, the doctor can check that the needle is inside the nodule before taking tissue. Noah Medical also said its system had passed 15,000 procedures in the US. Hospitals are still adding robots: in September 2026 AdventHealth Redmond in Georgia and Adventist Health Bakersfield in California both announced new robotic bronchoscopy programs.

Person seated at a large surgical robot console in an operating room while staff in scrubs watch
Person seated at a large surgical robot console in an operating room while staff in scrubs watch

A visitor tries the console of a da Vinci Xi, made by Intuitive, the company behind the Ion bronchoscopy robot, at Keesler Medical Center in 2017. Photo: Kemberly Groue / U.S. Air Force via Wikimedia Commons (public domain)

ABB does not make a bronchoscopy robot, and nothing suggests it plans to. Its robots show up after the biopsy. The tissue goes to a pathology lab, and in July 2026 ABB Robotics and Roche Diagnostics announced a global collaboration on lab automation. The first projects are robots that handle and sort pathology slides and mobile robots that carry samples between instruments. ABB has already shown GoFa CRB 15000 cobots and a mobile YuMi concept working at lab instruments, much like the systems in our post on hospital lab automation.

Two white ABB robot arms on a lab bench between analysers with racks of sample tubes
Two white ABB robot arms on a lab bench between analysers with racks of sample tubes

ABB robot arms working between analysers in a clinical laboratory, shown with the ABB and Roche collaboration. Photo: ABB

Where robotic bronchoscopy goes next, from screening to treatment

The next goal is treatment. Today the robot finds the nodule and takes a sample, and if it is cancer the patient usually needs surgery or radiation at a later date. Doctors and companies are testing ways to destroy small tumours through the same catheter in the same visit, using heat, cold or other energy. Lung cancer screening programs keep finding more small nodules, so the demand for precise biopsy should grow with them. Robots that work alongside 3D imaging, as in the Noah Medical and GE HealthCare news, are aimed at exactly this.

White ABB GoFa cobot arm at work in a bright laboratory setting
White ABB GoFa cobot arm at work in a bright laboratory setting

A GoFa cobot at ABB's healthcare research hub. Photo: ABB

For ABB, the realistic openings are in factories and labs. Robotic catheters, scopes and imaging systems are small, precise products made in clean rooms. At GE Healthcare's prototype line in Helsinki, a single-arm YuMi IRB 14050 already lays fine glue beads on small sensor parts, a job covered in our post on medical device assembly. Cells like that could, as a possibility, assemble or test bronchoscopy catheters too. Their programs are usually built and checked first in ABB RobotStudio simulation software before the real cell is built.

Small one-armed ABB YuMi robot inside a compact work cell with guarding
Small one-armed ABB YuMi robot inside a compact work cell with guarding

A single-arm YuMi IRB 14050 in its cell on GE Healthcare's prototype line in Helsinki. Photo: ABB

Cost is the first open problem. A robotic bronchoscopy platform is a large purchase, so smaller hospitals often wait. Studies comparing the robots with older methods are still being published, and doctors debate how much of the gain comes from the robot and how much from better imaging. Each team also needs training, and the pulmonologist who reads the scan and plans the route still makes the decisions. For the wider story of robots in the operating room, read our post on surgical robots.

Dual arm white robot on a mobile base standing in a bright hospital laboratory corridor
Dual arm white robot on a mobile base standing in a bright hospital laboratory corridor

ABB's mobile YuMi concept, a dual arm robot on a wheeled base, in a hospital lab corridor. Photo: ABB

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