This single-institution study evaluated 78 patients undergoing single-anesthetic robotic bronchoscopy with intraoperative biopsy, followed by possible lung resection. Intraoperative frozen section diagnoses showed almost perfect agreement with final pathology (Cohen’s kappa 0.94), supporting their reliability for surgical decision-making. The diagnostic yield improved over time, reaching 80.8 percent in the late phase. The rate of unnecessary benign resections decreased significantly as experience grew, dropping to zero percent in the late phase. No malignancies were missed when surgery was aborted based on benign biopsy.