Pulmonary Self-Study Resources-Endobronchial Sampling: Forceps

Video Transcription

With minimal bleeding from our endobronchial needle aspiration, we will now proceed with endobronchial forceps biopsies. Again sampling our lesion and our bronchus intermedius.  Advancing forceps. Initially, you can move fast, but then slow down so the forceps doesn't inadvertently traumatize the tumor.  The forceps can be opened prior to sampling the target to ensure that you are appropriately aligned. Open. Open.  And now we will advance the scope and our forceps to our target lesion. Close.  The forceps are closed on the site and our sample is withdrawn. And the specimen is deployed in the specimen cup.  In cases of necrotic tumor, you may need to take multiple samples before reaching viable tumor cells for pathology.  For friable lesions or lesions likely to bleed, you may also choose to pre-treat with cold saline to minimize your risk of bleeding. Open. Open. Gentle pressure. Close. Close.  It's advisable to biopsy until viable tumor is visualized, either by a slight bleeding or a pinkish mucosa.  This lesion in this view looks very necrotic and it's likely that biopsies until now will all show necrotic tumor and may be non-diagnostic.  There is a saying that when it comes to endobronchial biopsy, we biopsy until we see a slight bleeding.  Usually for endobronchial lesions, four to five biopsies should suffice when it comes to diagnosing malignancy. Open.  Close.

Video Summary

The video explains the procedure for endobronchial forceps biopsies to sample lesions and bronchus intermedius. It is important to move slowly to avoid unintentional trauma to the tumor. The forceps are opened before sampling to ensure proper alignment. Multiple samples may be needed for necrotic tumors, while pre-treating with cold saline can reduce bleeding for fragile or bleeding-prone lesions. Biopsies should continue until viable tumor cells are visible, typically indicated by slight bleeding or pink mucosa. It is recommended to take four to five biopsies for diagnosing malignancy in endobronchial lesions.

Meta Tag

Asset Type Video

Curriculum Category Pleural Disease

Curriculum Subcategory Diagnostic and therapeutic procedures

Keywords

endobronchial forceps biopsies

lesions

tumor sampling

necrotic tumors

diagnosing malignancy