Date: 8/11/2011

Lung Biopsy Patients benefit from New Minimally-Invasive Technology

Patients with lung disease seeking quicker results and a less invasive diagnostic experience will benefit from new technology being used by pulmonologists at St. Mary Medical Center in Hobart. Endobronchial ultrasound (EBUS) is a relatively new procedure used to diagnose lung cancer, infections or other diseases causing enlarged lymph nodes in the chest. Currently, St. Mary Medical Center is one of the few hospitals in Indiana to offer EBUS, a minimally invasive procedure that allows for speedy results.

EBUS allows physicians to perform a technique known as transbronchial needle aspiration (TBNA) to obtain tissue or fluid samples from the lungs and surrounding lymph nodes without surgery. The samples can be used for diagnosing and staging lung cancer, detecting infections, and identifying inflammatory diseases that affect the lungs.

“Endobroncial ultrasound-guided needle biopsies are becoming the preferred method for identifying and staging lung cancers,” says Charles Rebesco, M.D., board certified pulmonologist on staff at St. Mary Medical Center. “With the proper training and equipment, these minimally invasive procedures not only allow us access to more lymph nodes in the chest, we can perform our diagnostic and staging procedures within about an hour without surgery.”

Equally important, adds Rebesco, is that since EBUS is performed endoscopically, there is no scarring of tissue as there is with conventional surgical methods of staging lung cancers.

With EBUS, the physician is able to perform needle aspiration on the lymph nodes using a bronchoscope inserted through the mouth; no incision is necessary. A special endoscope fitted with an ultrasound processor and a fine-gauge aspiration needle is guided through the patient’s trachea. This technology provides real-time imaging of the surface of the airways, blood vessels, lungs, and lymph nodes. The highly defined, 3D images allow the physician to easily view previously difficult-to-reach areas and to reach more, and smaller, lymph nodes for biopsy with the aspiration needle than through the conventional surgery, called mediatinoscopy.

Mediastinoscopy is the ‘gold standard’ method for determining the presence of cancer in the lungs. Generally performed as an outpatient surgical procedure, it is associated with a low rate of complications and a high rate of accuracy. A small incision is made in the neck just above, or next to, the breastbone. Then, a thin scope, called a mediastinoscope, is inserted through the opening to provide access to the lungs and surrounding lymph nodes. Tissue or fluid is then gathered for examination.

But, many pulmonologists, including Rebesco are adopting the new technique for its diagnostic advantages. The accuracy and speed of the EBUS procedure enables a more rapid on-the-spot pathologic evaluation. Pathologists in the operating room can process and examine biopsy samples as they are gathered and can request additional samples to be taken at the same time, if necessary. This eliminates the need for the patient to be sedated again or come back for another biopsy procedure. With no incision, patients recover quickly and in most cases, go home the same day.

For more information about the cutting-edge technology and minimally invasive procedures offered by St. Mary Medical Center in Hobart, visit