Narrow Band Imaging (NBI) and Autofluorescence Imaging (AFI) are two modalities that are deservedly gaining greater interest in the medical community. To a significant degree, this is due to their ability to provide more information that can lead to faster and more accurate diagnosis of a number of conditions.

Autofluorescence Imaging (AFI) and Narrow Band Imaging (NBI) are two modalities that are deservedly gaining greater interest in the medical community. To a significant degree, this is due to their ability to provide more information that can lead to faster and more accurate diagnostics, particularly relating to tissue thickening. With benefits like these, the arguments for using each are very persuasive.

Endobronchial ultrasound (EBUS) using Olympus mechanical radial ultrasound miniature probes and catheters, improves diagnostics in the airways, including T-staging and diagnosis of solitary pulmonary nodules (SPN). Catheters incorporating a balloon at the tip allow circular contact in the larger lumen, while radial EBUS probes provide a complete 360° image of the parabronchial structures and enable visualisation of structures up to a distance of 4cm.

Peripheral pulmonary coin lesions can be accessed using a range of techniques. These include percutaneous access (needle aspiration), via VATS (video assisted thoracotomy surgery), through open surgery or with an endobronchial procedure. Of these techniques, endobronchial sampling is the least invasive and most cost effective.

Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a reliable and commonly established technique, which can be perceived as the current gold standard that enables visualisation and sampling of mediastinal, central or hilar lesions within the bronchial tree.

Transbronchial needle aspiration (TBNA) is used for diagnosis and staging of bronchial diseases, including mediastinal or peripheral pathologies, subcarinal and parabronchial nodes and parenchymal abnormalities.

While performing bronchoscopy with a flexible bronchoscope it can be necessary to obtain some yield from a lesion with the help of biopsy forceps to establish a diagnosis of the target lesion.

In brush cytology, endobronchial bronchoscopy is used to collect cells from the airways to enable diagnosis of diffuse diseases, visible airway mucosal abnormalities, peripheral lesions or peripheral lung infiltrates. Bronchial brushing is also used to reveal cancer, inflammations and infections.

Bronchoalveolar lavage (BAL) is a diagnostic procedure where lavage fluid is introduced to the terminal bronchioles and then recollected for analysis to examine cells, inhaled particles, infectious organisms or fluid constituents.

Local anaesthesia application in respiratory tract is used before passing the vocal cords and topically on the trachea and carina before interventions.

Bronchoscopic electrosurgery (electrocautery ) can be used for a number of diverse bronchoscopy applications. For example, tumour ablation and debulking, cauterisation of lesions, haemostasis and bronchial biopsies.

Interventional bronchoscopy is a minimal invasive option to remove foreign bodies. Due to the size and consistency of the object as well as the location limiting access to the foreign body a thorough procedure and device planning is necessary.

Hemostasis can be achieved through coagulation, tamponade with a balloon catheter or ice cold saline via a standard catheter.

Drug and dye application in the respiratory tract combines superficial (e.g. local anaesthesia) and subsurface (e.g. TBNI, TransBronchial Needle Injection) treatment. Use of catheters allows dispersion of liquids, including drugs, dyes and local anaesthetic in the respiratory tract.

The benefits of bronchoscopy techniques include accurate diagnosis of lung conditions and removal of foreign objects, mucus or sputum from the airway.

Direct examination of the thoracic cavity can be achieved through medical thoracoscopy under local anaesthesia enabling pleural biopsy. Pleural biopsy is a procedure to remove a sample of the tissue lining the lungs and the inside of the chest wall to check for disease or infection.

In 1910, Jacobaeus used a rigid cystoscope to inspect the pleural cavity endoscopically. Soon medical thoracoscopy was widespread, but confined to specialised centres or departments. The single hole technique remained the most widely accepted way to access the pleural space. After a small incision under local anaesthesia, a trocar is inserted, providing access for rigid optical instruments.

For the treatment of diseased lung (for example, emphysema), the valve redirects air from the diseased portions of the lung to healthier areas and allows atelectasis if intended. Selected case studies have shown improvement of disease-related quality of life and lung function.

For the treatment of damaged lung (for example, air leak), the valve limits airflow to injured tissue, which may enable healing. In selected cases prolonged post surgical air leaks as well as persistent and spontaneous secondary air leaks have been treated.

Interventional bronchoscopy is a minimal invasive option to remove foreign bodies. Due to the size and consistency of the object as well as the location limiting access to the foreign body a thorough procedure and device planning is necessary.

Paediatric endobronchial biopsy involves obtaining a small sample of tissue that contains all relevant structures and cells for histological analysis.

In children brush cytology is performed endoscopically to sample cells from the surface of lesions or diseased mucosa for cytological analysis, evaluation of infections such as tuberculosis or for ciliary studies.