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Navigational Bronchoscopy

(Electromagnetic Navigational Bronchoscopy)

Definition

A bronchoscopy is the visual examination of the air passages of the lungs. It is done with a tool called a bronchoscope. This tool is a long, thin tube with a camera at the tip. Special surgical tools can also be passed through the tube. The tools may take tissue samples or mark an area for treatment.
A CT scan is used to create images to map the airways. The images are downloaded into a computer which helps navigate the bronchoscope into the smaller airways of the lungs.
IMAGE
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A navigational bronchoscopy may be done to help diagnose or treat problems in small airways of the lungs. It is often done after an x-ray , or MRI or CT scan shows a suspicious spot. Navigational bronchoscopy may be done to:
  • Take a biopsy of lung tissue
  • Place markers for future treatment
  • Insert internal radiation therapy catheters into cancerous lung tissue
This procedure may prevent an open surgery, which has greater risks and longer recovery time. It can help provide early diagnosis of lung cancer.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
  • Bleeding
  • Collapsed lung
  • Irregular heart rate
  • Infection
  • Sore and swollen throat
Smoking may increase the risk of having these problems.

What to Expect

Prior to Procedure

Your doctor may do some or all of the following:
  • Physical exam
  • Blood tests
Talk to your doctor about your current medications. You may be asked to stop taking some medications up to one week before the procedure.
Leading up to your procedure:
  • Arrange for a ride to and from the medical center.
  • Eat a light meal the night before. Do not eat or drink anything after midnight.

Anesthesia

Local anesthetic will be given to numb the throat. It will also help to prevent coughing and gagging. You may also be given medication to help you relax.
Sometimes, a bronchoscopy is done under general anesthesia. In this case, you will be asleep.

Description of the Procedure

A CT scan will be done. Images from the scan will be loaded into a special computer. The computer program will highlight were the problem areas are located. Your doctor will use this information to guide the scope.
You will be asked to lie on a special table.
The bronchoscope tube will be inserted through the mouth. It will then be passed down the throat and into the lungs. Special tools will be passed through the tube. One tool will have an electromagnetic sensor. This sensor will show the doctor exactly where it is in the lungs. The doctor will use the sensor and the CT scans to reach the appropriate area in the lungs.
A small sample of tissue may be taken from the area. The sample will be removed through the scope. Small metal markers may also be placed around the area. These markers will help with future treatment.
The tools and scope will be removed once the doctor is done.
Tissue samples will be sent to a lab. The tissue will be examined for cancer or infections.

How Long Will it Take?

Less than 1 hour

Will it Hurt?

Anesthesia prevents pain during the procedure. You may have some soreness in your throat and hoarseness for a few days after the procedure. Pain and discomfort after the procedure can be managed with medications.

Post-procedure Care

A chest x-ray may be taken before you go home.
You will feel sleepy after the procedure. Do not drive until your doctor says it is safe to do so.
When you return home, do the following to help ensure a smooth recovery:
  • Spit out saliva. Do not try to swallow it while your throat muscles are numb.
  • Do not eat or drink anything while your throat is numb. The numbness may last for about two hours.
  • When you are able to eat, start with sips of water. Progress to solid food when ready.
  • If you had a biopsy, try not to cough or clear your throat.
  • If you had to stop medications before the procedure, ask your doctor when you can start again.
  • Resume your normal diet, unless told otherwise by your doctor.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:
  • Signs of infection, including fever and chills
  • Cough, shortness of breath, or chest pain
  • Coughing up more than a small amount of blood
  • Severe nausea or vomiting
  • Increased or unusual wheezing or stridor
  • Pain that you cannot control with the medications you have been given
If you think you have an emergency, call for medical help right away.

RESOURCES

American Lung Association http://www.lung.org

American Thoracic Society http://www.thoracic.org

CANADIAN RESOURCES

Canadian Lung Association http://www.lung.ca

Health Canada http://www.hc-sc.gc.ca

References

Edell E, Krier-Morrow D. Navigational bronchoscopy. Chest. 2010;137(2):450-454.

Electromagnetic navigational bronchoscopy. Alta Bates Summit Medical Center website. Available at: http://www.altabatessummit.org/technology/enb.html. Accessed August 21, 2014.

Explore Bronchoscopy. National Lung Heart and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/bron. Updated February 8, 2012. Accessed August 21, 2014.

Leong S, Ju H, et al. Electromagnetic navigation bronchoscopy: A descriptive analysis. J Thorac Dis. 2012;4(2):173-185.

Navigational bronchoscopy. Wellmont Health Systems website. Available at: http://www.wellmont.org/Our-Services/Pulmonology/Navigational-Bronchoscopy. Accessed August 21, 2014.

Navigational bronchoscopy. University of Louisville Medical Center website. Available at: http://www.university-hospital.org/programs-services/lung-services-at-university-of-louisville-hospitaljames-graham-brown-cancer-center/navigational-bronchoscopy. Accessed August 21, 2014.

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