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  The forceps are closed on the site and our sample is withdrawn.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

In this video, the speaker discusses the process of performing endobronchial forceps biopsies. They explain the importance of moving slowly to avoid trauma to the tumor and suggest opening the forceps before sampling to ensure proper alignment. They also mention the use of cold saline for friable or bleeding-prone lesions. The speaker advises continuing biopsies until viable tumor cells are seen, usually indicated by slight bleeding or a pinkish mucosa. They caution that in cases of necrotic tumors, multiple samples may be needed before obtaining a diagnostic specimen. Generally, four to five biopsies are sufficient to diagnose malignancy in endobronchial lesions.

Keywords

endobronchial forceps biopsies

moving slowly

opening forceps before sampling

cold saline

viable tumor cells