Endobronchial Ultrasound

After spending a week’s worth of work experience in an infirmary in West Yorkshire, I now feel significantly more aware of what an effect modern technology has on the medical world. Having been based in a hospital to which Robotic Prostatectomies are now a commonly used procedure, I really did feel ‘on the forefront’ of medical technology. However, my time was not spent shadowing oncologists, but rather in the centre of a hectic respiratory ward on the second floor of the infirmary. It was here that colleagues introduced me to a procedure named EBUS-TBNA.
EBUS-TBNA (or Endobronchial Ultrasound-guided Transbronchial Needle Aspiration) is a procedure which allows consultants to view the inside of patients’ airways, without any large and potentially dangerous incisions. The procedure also allows samples of tissue outside the lungs to be taken, allowing for analysis to check for any abnormalities.
So how is EBUS-TBNA actually carried out? Well, a thin and flexible bronchoscope (similar to a telescope) is inserted down the trachea and through the bronchi. All the while ultrasound is used to guide the bronchoscope and aid the doctor. The ‘aspiration’ basically involves an incredibly thin needle being slid out of the bronchoscope and through any tissue walls which doctors require samples of. The needle can also penetrate tissue and take samples from the other side of a tissue wall, hence how EBUS-TBNA can take tissue samples from outside of the lungs. This makes EBUS-TBNA particularly useful as it provides access to the mediastinum, an area which is usually very difficult to access.
EBUS-TBNA seems very impressive so far but what is it actually used for? And why should we care? EBUS-TBNA is a great tool for cancer staging within and outside of the bronchi. This is done by assessing how far and at what rate the cancer has spread throughout the body. Without the access EBUS-TBNA provides this monitoration would be almost impossible and patient awareness of cancer would be scarce.
Patients suffer few side effects from the procedure including mild chest pain, coughing up blood and throat soreness however these minor setbacks are in my opinion, greatly outweighed by the benefits and information which EBUS-TBNA provides both doctor and patient alike with.

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