Bronchoscopy and airway procedures

Which procedure has been recommended to you?

The three procedures answer different questions, and knowing which one you are booked for tells you a lot about what your team is trying to establish.

• Flexible bronchoscopy is for looking at the airways and sampling the lung itself. Sedation, day case. Read bronchoscopy.
• EBUS-TBNA is for lymph nodes in the centre of the chest, most often to stage a lung cancer or to find out whether enlarged nodes are tuberculosis, sarcoidosis or something else. Read EBUS-TBNA.
• Rigid bronchoscopy is for treating a large airway rather than investigating it, under general anaesthesia. Read rigid bronchoscopy.

These are frequently combined. An EBUS is performed with a flexible scope in the same sitting, and a flexible scope is often passed through a rigid one to reach further into the smaller airways.

Procedures covered elsewhere

The interventional pulmonology service page covers the wider range of airway and pleural work, including balloon dilatation, cryotherapy, electrocautery and laser, airway stenting, medical thoracoscopy and pleural procedures. Post-transplant airway management is described in airway complications after lung transplant.

Before you consent to any of them

Three questions are worth asking, and a good team will answer all of them without hesitation. What specific question is this procedure meant to answer? What happens if the result comes back negative or inconclusive, does the investigation stop there or does another step follow? And is there a less invasive test that would answer the same question?

If you have been advised to have a surgical lung biopsy, it is particularly worth asking whether a cryobiopsy would give the same answer, since it avoids general anaesthesia and a chest drain for many patients. A second opinion before an invasive procedure can be issued from your existing scans and reports without an in-person visit.

Where these are performed

All three are performed by Dr. Manjunath M Negigoudara at KIMS Hospital, Electronic City, Bengaluru, where thoracic surgery and ECMO are available on site. He holds a Fellowship in Interventional Pulmonology from Manipal Hospitals alongside MD in Pulmonary Medicine and DNB in Respiratory Medicine. Call or WhatsApp +91 79937 41199, Monday to Saturday, 9 AM to 5 PM.