Background: Bronchoscopic thermal ablation has emerged as a minimally invasive therapeutic option for managing pulmonary nodules in patients unsuitable for surgery or radiotherapy. Robotic-assisted bronchoscopy (RAB) offers enhanced stability and precise navigation, potentially improving the safety and accuracy of bronchoscopic ablation. However, clinical data on RAB-guided microwave ablation (MWA) remains limited. Therefore, further evidence is needed to evaluate its feasibility, safety, and early therapeutic performance. Methods: We conducted a single-center retrospective feasibility study of shape-sensing RAB-guided MWA (ssRAB-MWA) for pulmonary nodules between October 2024 and September 2025. Eligible lesions (≤3.0 cm) included both primary lung cancers and metastatic nodules. All procedures were performed under general anesthesia using the ssRAB system integrated with cone-beam CT for intra-procedural confirmation. Technical success, safety outcomes, and short-term efficacy were assessed. Results: Nine patients (with 11 lesions: 3 primary, 8 metastatic) underwent ssRAB-MWA with 100% technical success. The median ablation time per nodule was 10 min (range, 1–26). One patient developed post-ablation pneumonia requiring hospitalization; no pneumothorax, major bleeding, or airway injury occurred. All lesions exhibited a transient increase in size immediately following MWA, followed by gradual reduction or stabilization over time. PET-CT evaluation demonstrated metabolic remission in primary lesions, with one patient achieving pathologic complete response after surgery. Conclusions: ssRAB-MWA appears to be a feasible and safe navigation-guided technique for small pulmonary lesions, offering encouraging early local control in both primary and metastatic lung cancers. This platform may expand the therapeutic spectrum of interventional pulmonology, bridging diagnosis and local therapy. Larger multicenter studies are warranted to validate long-term outcomes.

Sessile serrated lesions (SSL) of the appendix are rare appendiceal neoplasms, often identified incidentally on appendix resection and only rarely discovered prior to surgery. This study aims to better characterize appendiceal SSL and their relation to other appendiceal neoplasms. The anatomic pathology database was reviewed for all cases in which the appendix was resected from 2015 to 2023. Cases with a diagnosis of appendiceal sessile serrated lesion were included in the study. Indications for resection and available molecular testing were identified through the electronic medical record. A total of 103 cases of appendiceal SSL were identified. The majority of resections were performed for non-neoplastic indications, either for acute appendicitis or incidentally during a different surgical procedure. SSL was most commonly seen concurrently with low-grade appendiceal mucinous neoplasm, high-grade appendiceal mucinous neoplasm, and primary appendiceal adenocarcinoma, co-presenting in 15, 4, and 12 cases respectively. Molecular data was available for a small subset of cases co-presenting with cancer, with KRAS and GNAS being the most commonly mutated genes. We demonstrate that appendiceal SSL can be seen in conjunction with other appendiceal neoplasms, predominantly appendiceal mucinous neoplasms and primary appendiceal adenocarcinoma. Appendiceal mucinous neoplasia or adenocarcinoma typically presents at a high clinical stage when present concurrently with SSL. Similar to other studies, appendiceal SSL are most commonly an incidental diagnosis, typically in the context of appendectomy for acute appendicitis.