Shape-sensing robotic-assisted bronchoscopy has emerged as a promising technique for volume reduction in giant emphysematous bullae (GEB), offering a minimally invasive approach to manage this challenging condition. This case report highlights the successful application of this technology in a patient with GEB, achieving significant symptomatic improvement and volume reduction. The patient, a long-term smoker with a history of chronic obstructive pulmonary disease (COPD) and a previous pneumothorax, presented with progressive shortness of breath. Post-admission assessment revealed a GEB in the right lung, compressing approximately 60% of the entire right lung. The patient's history of bulla rupture and the need to improve daily activity tolerance led to the decision to explore therapeutic alternatives. Shape-sensing robotic-assisted bronchoscopy (ssRAB) was chosen due to its precision and stability, allowing for the aspiration of gas within the bulla and the injection of adhesive under direct endoscopic observation. The procedure was performed under general anesthesia, and the patient exhibited no significant postoperative discomfort. Follow-up imaging showed a substantial reduction in bulla volume, with improved shortness of breath and enhanced quality of life. This case demonstrates the potential of ssRAB as a safe and effective treatment for GEB, offering a minimally invasive alternative to surgical lung volume reduction. However, further research is needed to explore long-term functional outcomes and the potential for pneumothorax prevention.
