Advanced bronchoscopy is a minimally invasive outpatient procedure that is primarily used to biopsy, diagnose, and stage lung nodules, masses, or cancers.

Compared to traditional lung biopsies, advanced bronchoscopies have fewer complications and can typically produce quicker and more accurate results. Lung biopsies done with a needle through the chest have a fairly high complication rate and also do not stage cancer, potentially resulting in patients needing more procedures to confirm results.

Advanced bronchoscopy has also been used to more accurately diagnose other non-cancerous conditions including asthma, sarcoidosis, emphysema, and other interstitial lung diseases.

During an advanced bronchoscopy, a tube known as a bronchoscope is inserted through the mouth into the lungs. A small camera is attached to the end of the bronchoscope, allowing the doctor to view and take a sample of any abnormal lung tissues. New technology has made it possible for 360 degree visualization of the airways as well as improved ease of navigating deeper or harder to reach portions of the lung.

Patients are typically sedated during the procedure, which takes roughly one hour to complete.

After a tissue sample is retrieved, a pathologist examines it for any abnormalities. In cases of cancer, tests are able to identify the stage of the cancer as well as specific molecular markers. Depending on the results, your pulmonologist may recommend other surgeries or refer you to a medical oncologist. Treatment plans are often highly individualized.

In most cases, an advanced bronchoscopy is performed to help with diagnosis of a lung condition. Doctors may recommend an advanced bronchoscopy for patients who have:

• A lung infection
• Chronic breathing problems
• Abnormal chest X-ray results
• A lung nodule, mass, or tumor
• An obstruction of the airways
• Narrowing of the airways
• Collapsed lung

Although uncommon, there are a few possible complications of advanced bronchoscopy. Some patients may experience minor soreness from the bronchoscope going through the airways. If a biopsy was taken, there is also a small chance of bleeding that typically stops quickly and on its own. In an estimated 2-3% of advanced bronchoscopies performed, the lung can be punctured, leading to a collapsed lung.

Preparation for advanced bronchoscopy typically involves a few restrictions prior to the procedure. Patients are advised to not eat or drink within a few hours of an advanced bronchoscopy. Your doctor may also suggest that you temporarily stop taking medication such as aspirin or warfarin that thin the blood.

Additionally, due to anesthesia being used for the procedure, it may be helpful to have a friend or family member present to assist you in the few hours after an advanced bronchoscopy.

Advanced bronchoscopy is an outpatient procedure. In the majority of cases, recovery takes roughly two hours unless there are any complications during the procedure. Due to the anesthesia, some patients may experience some grogginess for about a day. By the next day, a patient should be able to go back to their normal routine.

Advanced bronchoscopy is a minimally invasive procedure. Risks of complications for advanced bronchoscopy are much lower than traditional lung biopsies, but they should still be considered. The majority of patients who undergo advanced bronchoscopy respond well to the procedure.