How EBUS works

Nagpur city is witnessing a lot of medical advancements. Recently young Interventional Pulmonologist from Nagpur, Dr Sameer Arbat performed the first EBUS procedure in Central India at KRIMS Hospitals. The first procedure was performed on 17th January 2018 followed by the second procedure on 18th January. This brings Nagpur among the very few cities in the country to have an EBUS setup.EBUS or “Endobronchial UltraSound” is a relatively new procedure used in the diagnosis of lung cancer, lung infections, and other diseases that cause enlarged lymph nodes or masses in the chest. The EBUS scope is a bronchoscope with an ultrasound attached to it. This ultrasound probe enables visualizing smaller structures like vessels and lymph nodes inside the chest. This allows physicians to view difficult-to-reach areas and to access more, and smaller, lymph nodes for biopsy or perform a technique known as transbronchial needle aspiration (TBNA) to obtain tissue samples without conventional surgery. The samples can be used for diagnosing and staging lung cancer, detecting infections, and identifying inflammatory diseases that affect the lungs, such as sarcoidosis. This leads to early diagnosis avoiding surgeries like mediastinoscopy, which involves giving an incision in the neck and inserting a tube.

There are two types of EBUS machines, Radial and Linear. While the radial EBUS has an advantage of finding far placed lesions inside the lung, it is the linear EBUS, which gives better access to enlarged nodes inside the mediastinum – the area between the lungs which contains the heart. Very few experts who are trained in EBUS can perform this complicated procedure. The EBUS technology is considered the best invention in chest medicine after the stethoscope, which was invented in 1816.“Intervention has a major role to play in the future for timely diagnosis and treatment. EBUS has already been established as an important tool for lung cancer staging. We performed our first case of Linear EBUS and Radial EBUS on consecutive days. It took me almost 2 years of training in Italy and higher centers in Delhi, Mumbai to achieve dexterity in handling the EBUS. This procedure helps the patient to get an early diagnosis and the patient can go home on the very same day, thus saving time and money,” said Dr Sameer Arbat. KRIMS Hospitals now has a fully functional lung cancer diagnostic unit with all modalities of interventional pulmonology.  “ We are the first in Central India to have both Linear and Radial EBUS along with Cryotherapy Unit. Studies have shown that EBUS is cost-effective as it reduces the need for a more morbid and costly invasive procedure like mediastinoscopy or thoracotomy. The introduction of this facility will benefit the patients from Nagpur as well as Central India for early diagnosis of lung cancer, sarcoid, tuberculosis of mediastinal glands which is a boon for the lungs ” said Dr Ashok Arbat, senior pulmonologist, KRIMS Hospitals who is considered as one of the best pulmonologists in India.

Advantages of EBUS

  • It provides real-time imaging of the surface of the airways, blood vessels, lungs, and lymph nodes
  • The improved images allow the physician to easily view difficult-to-reach areas and to access more, and smaller, lymph nodes for biopsy with the aspiration needle than through conventional mediastinoscopy
  • The accuracy and speed of the EBUS procedure lend itself to rapid onsite pathologic evaluation. Pathologists in the operating room can process and examine biopsy samples as they are obtained and can request additional samples to be taken immediately if needed
  • EBUS is performed under moderate sedation or general anesthesia
  • Patients recover quickly and can usually go home the same day