Lung Biopsy Preparation

Biopsy of lung is a method for obtaining a tiny sample of lung tissue for microscopic examination. The tissue is generally examined under a microscope, and may be referred to a microbiological laboratory for further culture evaluation.

Preparation for Biopsy of Lung

At least 7 to 15 days prior to the procedure, the patient receives information about what to expect in the procedure and the expected recovery period. A chest X-ray or CAT scan of the chest is performed to detect the site to be biopsied.

About an hour prior to the biopsy procedure, the patient is administered a sedative. Drugs may also be applied to dry up airway secretions. General anesthesia is applied for this procedure.

For 12 hours prior to the biopsy of lung the patient is asked to stop eating or drinking anything. Before these procedures, an intravenous tube is inserted in a vein in the patient's arm to offer medications or fluids of necessary. A hollow tube, called an endotracheal tube, is sent to the lungs through the mouth. The purpose behind this tube placement is to deliver the general anesthetic. The chest area is cleansed with an antiseptic fluid. In the mediastinoscopy methodology, the neck is also cleansed to prepare for the incision.

Smoking Cessation

Patient is asked to quit smoking and using tobacco products. Patients who quit smoking weeks prior to the before surgical procedures have less postoperative complications.

Informed Consent

Informed consent is an agreement between healthcare providers and patients. The patient is asked to sign a consent form. Prior to signing the form, the patient is made to understand the nature and purpose of the diagnostic process, its risks and benefits encompassing the option of not proceeding with the test or treatment.

Process of Biopsy

Bronchoscopic Biopsy

During the bronchoscopy, a thin, light tube (bronchoscope) is passed through the passage of nose or mouth, down the trachea to the bronchi heading to the lungs. Through the bronchoscope, the physician views the airways, and clears mucus from blocked airways, and accumulates cells or tissue samples for laboratory analysis.

Needle Biopsy

The patient is slightly sedated, but awake while conducting the needle biopsy procedure. The patient sits on a chair with arms folded in front on a table. An X- ray expert facilitates a computerized axial tomography (CAT) scanner or a fluoroscope to ascertain the precise location of the suspicious areas. Markers are placed on the skin to identify the biopsy site. The skin is properly cleansed applying antiseptic fluid and a local anesthetic is administered to numb the area. The patient will feel a short stinging sensation when the anesthetic is administered.

The physician creates a tiny incision, about half an inch long. The patient is instructed to breathe deeply and hold it during the insertion of the biopsy needle via the incision into the lung tissue by the doctor. The patient may feel pressure and a brief sharp sting when the needle reached the lung tissue. The patient is instructed to refrain from coughing during the procedure. The needle is withdrawn once enough tissue has been obtained. Biopsy site is ceased by applying pressure and a sterile bandage is placed over the incision. A chest X-ray is conducted to just after the procedure to analyze the potential complications.

Open Biopsy

Open biopsy of lung is conducted in a hospital under the influence of general anesthesia. Once the anesthesia has started working, the surgeon creates an incision over the lung area. Some lung tissue is taken out and the incision is closed with sutures. Chest tubes are placed with one end within the lung and the other end projecting through the closed incision. Chest tubes are facilitated to flush out blood or fluid and re-expand the lungs. They are generally taken off after the procedure. A chest x ray is immediately performed after the procedure to check for potential complications.

Video-guided Thoracoscopic Surgery

A least invasive technique is video-assisted thoracoscopic surgery (VATS) which can be facilitated to biopsy lung and mediastinal lesions. VATS may be conducted on selected patients instead of open lung biopsy. While the patient is under the influence of common anesthesia, the surgeon creates several small incisions in the chest wall of the patient. A thorascope, a thin, hollow, light tube coupled with a tiny video camera is inserted through one of the small incisions. Other incisions are used by the surgeon to insert other instruments to retrieve tissue for biopsy.

Mediastinoscopy

This procedure is conducted under general anesthesia. A 2–3 inch incision is created at the base of the neck. A thin, hollow tube, termed as mediastinoscope, is placed through the incision into the place between the right and the left lungs. The surgeon takes out any lymph nodes or tissues seems to be abnormal. The mediastinoscope is then taken out and the incision is closed and bandaged property. A mediastinoscopy is performed in an hour.