# Bronchoscopy (EBUS, robotic navigation)

Source: https://onco.cc/terms/bronchoscopy/  
OnCo record `bronchoscopy` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Passing a camera down the windpipe into the lungs to biopsy tumours and lymph nodes without surgery.

## Summary

Endobronchial ultrasound (EBUS) samples mediastinal nodes through the airway wall and has largely replaced surgical mediastinoscopy for staging lung cancer. Robotic and electromagnetic navigation bronchoscopy reach small peripheral nodules found on screening CT, and are being coupled with ablation to treat them in the same session. Tissue yield matters because a modern lung cancer diagnosis needs enough for PD-L1 and a genomic panel.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: bronchoscopic; flexible bronchoscopy; robotic bronchoscopy; navigational bronchoscopy

## Notes

- What NICE asks for, and what it dropped. NG122 offers endobronchial ultrasound-guided transbronchial needle aspiration for biopsy of paratracheal and peri-bronchial intra-parenchymal lesions, asks every cancer alliance to have at least one centre with endobronchial or oesophageal ultrasound and to audit local test performance, and removed transthoracic needle biopsy, plain bronchoscopy and non-ultrasound-guided needle aspiration from the staging of intrathoracic nodes because they do not reach the sensitivity the British Thoracic Society quality standards require. Flexible bronchoscopy is still offered for central lesions when the nodal stage does not influence treatment.
- Lung cancer: the NHS names CT and bronchoscopy as the two main tests, describing bronchoscopy as a thin flexible tube with a small camera passed down the throat into the lungs. NICE NG122 (1.2.8) says to offer endobronchial ultrasound-guided transbronchial needle aspiration for biopsy of paratracheal and peri-bronchial intra-parenchymal lung lesions, (1.2.9) that every cancer alliance should have at least one centre with endobronchial or endoscopic ultrasound to ensure timely access, and (1.2.11) that samples must be adequate to permit subtyping and assessment of molecular markers.
- Bronchoscopy is also a route to treatment when an airway is blocked: NICE NG122 (1.14.1 to 1.14.3) says to monitor for endobronchial obstruction where there is large airway involvement, to offer external beam radiotherapy and/or endobronchial debulking or stenting for impending obstruction, and that every cancer alliance should ensure rapid access to a team capable of providing interventional endobronchial treatments.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Bronchoscopy
- Wikipedia: https://en.wikipedia.org/wiki/Bronchoscopy
- NICE NG122: lung cancer, diagnosis and staging (published 28 March 2019, last updated 8 March 2024): https://www.nice.org.uk/guidance/ng122/chapter/Diagnosis-and-staging
- NICE NG122: lung cancer, diagnosis and staging: https://www.nice.org.uk/guidance/ng122/chapter/Diagnosis-and-staging
- NHS: tests and next steps for lung cancer: https://www.nhs.uk/conditions/lung-cancer/tests-and-next-steps/
- Cancer Research UK: treatments to help you breathe when you have lung cancer: https://www.cancerresearchuk.org/about-cancer/lung-cancer/treatment/help-you-breathe

## Connected records

- terms: [Core needle biopsy and fine-needle aspiration (FNA)](https://onco.cc/terms/core-needle-biopsy/), [Endobronchial ultrasound (EBUS-TBNA)](https://onco.cc/terms/ebus-tbna/), [Haemoptysis (coughing up blood)](https://onco.cc/terms/haemoptysis/), [Mediastinal lymph node stations](https://onco.cc/terms/mediastinal-lymph-node-stations/), [Mediastinum](https://onco.cc/terms/mediastinum/)
- cancers: [Childhood lung and airway tumours (pleuropulmonary blastoma, tracheobronchial tumours)](https://onco.cc/cancers/pleuropulmonary-blastoma/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Lung neuroendocrine tumours (typical and atypical carcinoid)](https://onco.cc/cancers/lung-net/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Resectable stage I to III non-small-cell lung cancer](https://onco.cc/cancers/resectable-nsclc/), [Small-cell lung cancer](https://onco.cc/cancers/sclc/)
- fronts: [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/)
- technologies: [Endoscopic ultrasound and EBUS systems](https://onco.cc/technologies/endoscopic-ultrasound-systems/)

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