Transbronchial biopsy

A transbronchial biopsy is a procedure to perform a lung biopsy (removing a small piece of lung tissue). Your consultant has recommended a transbronchial biopsy, to find out if there is a problem in your lungs.

Alternatives

An X-ray or scan can show that you have a problem. However, a biopsy will help to find out exactly what is causing the problem.

The procedure

You won’t be able to eat anything for four hours before the procedure, but you may drink water up to two hours before the procedure.

Your doctor will give you a sedative to help you relax and will usually use local anaesthetic gel and spray to numb your nose and throat. This can taste unpleasant. Your oxygen levels and heart rate will be monitored during the procedure.

A transbronchial biopsy usually takes less than half an hour. Your doctor will pass a flexible telescope (bronchoscope) through your nose and down into your lungs. Sometimes they will pass the bronchoscope through your mouth instead of your nose. Your doctor will use the bronchoscope to examine your airways (bronchi). They will then gently push small forceps down one of your airways (a bronchus) into your lung. Your doctor will use the forceps to take samples of lung tissue. They may use an X-ray machine to help guide them while they perform the biopsy. The samples will be examined under a microscope to find out the cause of your problem. You will usually have a chest X-ray after the procedure.

For more information, and if you have any queries about the procedure, speak to your consultant.

Continue your normal medication unless you are told otherwise.

The following lifestyle changes can help make the procedure a success:

• Giving up smoking
• Eating healthily. If overweight, you have a greater chance of developing complications
• Exercising regularly. Your GP can recommend exercises.

Possible complications

• Breathlessness, which quickly settles after the procedure. Sometimes breathing can be more difficult due to the effect of the sedation or inhaling saliva. Your oxygen levels will be monitored and you will be given oxygen if needed
• Pneumothorax, where air escapes into the space around the lung. Usually a pneumothorax is small and does not cause any problems
• Bleeding from a biopsy site, which is usually minor and stops on its own. It is normal to cough up some streaks of blood for a day or two after the procedure
• Developing a high temperature a short while after the procedure, which is easily treated with paracetamol
• Developing a sore throat, which gets better quickly.

This is not a definitive list and symptoms will vary with each patient. Please ask your consultant for more information.

Recovery

Once you are awake enough and able to swallow properly, you will be given a drink (normally about two hours after the procedure). You should be able to go home after you have recovered from the sedative. Remember, you won’t be able to drive home after the procedure.

Once at home, if you have severe chest pain, continued vomiting, a high temperature lasting more than twelve hours, sudden breathlessness, or you cough up more than a tablespoon of blood, let your doctor know straightaway.

A member of the healthcare team will tell you what was found during the transbronchial biopsy and will discuss with you any follow-up treatment you may need. You may need to come back to the clinic a few days after the procedure for biopsy results.

You should be able to go back to work the day after the transbronchial biopsy. You should normally not fly for one month after having a transbronchial biopsy. If you have a small pneumothorax, it may get bigger during the flight, making it difficult for you to breathe. If you want to fly in less than one month, you should discuss this with your doctor.

For further information, speak to your consultant or a member of the endoscopy team.

Paying for your procedure

Transbronchial biopsy costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the procedure will be explained and confirmed in writing when you book the procedure. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.