Role of Endobronchial Navigation in Lung Cancer Management

The landscape of lung cancer management is undergoing a transformative paradigm shift, shifting from the traditional focus on solitary tumors to the recognition and treatment of small, multifocal, ground-glass lesions—a change driven predominantly by the widespread adoption of low-dose computed tomography screening. These multifocal tumors pose unprecedented diagnostic and therapeutic challenges due to their minute size, often subsolid consistency, and complex distribution within the lung. To address these complexities, pioneering technological innovations have emerged to enhance lesion localization accuracy and elevate treatment precision. Among these, the advent of advanced navigation bronchoscopy stands out as a groundbreaking development, revolutionizing both diagnostic workflows and local ablation strategies, thereby fundamentally redefining the management of multifocal lung tumors. This approach has yielded remarkable clinical outcomes, characterized by superior efficacy and a highly favorable safety profile. Further elevating this field are integrations of robotic-assisted bronchoscopy, hybrid operating room, and artificial intelligence—collectively constituting a comprehensive, streamlined treatment pathway that aims to deliver a cohesive, minimally invasive, one-stop solution for lung cancer therapy. As these technologies continue to evolve, an array of innovative bronchoscopy systems and ablative modalities remain at the forefront of ongoing research and development. In this chapter, we will explore the transformative role of navigation bronchoscopy in lung cancer management, critically examine the latest technological breakthroughs, and project future directions poised to redefine therapeutic standards in this rapidly evolving domain.