An EBUS is a procedure that allows the doctor to look into your lungs (similar to a bronchoscopy) but them to take samples of the glands in the centre of your chest (mediastinum) using the aid of an ultrasound scan, these glands lie outside the normal breathing tubes (bronchi).

A flexible tube (bronchoscope), which is about the size of a man’s little finger, is passed into your lungs via your mouth (you will have a mouthguard and some protective glasses on) with you lying as flat as possible. A small camera at the end of the bronchoscope enables the doctor to look directly into your windpipe (trachea) and breathing tubes (bronchi). A small ultrasound probe
on the end of the camera allows the doctor to see the glands in the centre of the chest (mediastinum) and take samples under direct vision. Occasionally, it is useful to look down your gullet (oesophagus) at the same time with the same camera (the anesthetic in your throat allows this), as sometimes the glands can be sampled from the gullet which often causes less coughing and is more comfortable for patient with breathing difficulties (if this is a possibility, it would be discussed with you beforehand by the doctor).

Most commonly, Endobronchial ultrasound-guided transbronchial needle aspiration is done to take samples from the central lymph glands in the centre of your chest (mediastinum) which may be enlarged for a variety of reasons. In 9 out of 10 cases, we would expect this test to give a helpful answer to the problem. Very occasionally, another test may be needed.

During the procedure

• This test is done under sedation (unlike normal bronchoscopy).
• A combination of 2 sedatives are given. 1 of these also helps reduce coughing. Some patients go off to sleep more or less completely, others simply find that they feel comfortable and relaxed. Following sedation patients may not remember anything about the test.
• Some anaesthetic spray will be gently put in the back of your throat – there may be a taste similar to bitter bananas. There will be a different sensation to breathing and swallowing as the throat becomes temporarily “frozen” but you will be able to breathe and swallow normally (it may just feel a little different). It is also fine to cough, which will subside later during the procedure.
• During the bronchoscopy you may feel some slight discomfort as the bronchoscope is passed through your mouth. This may make you cough, but as the anaesthetic takes effect your throat will relax and you will be able to breathe normally.
• Further anaesthetic is put down at the level of the voice box which may make you cough to start with but will quickly settle down.
• The whole procedure takes about 20-30 minutes.

You will receive a follow up appointment in approximately two weeks afterwards, when the results will be discussed with you.

For more information, download patient information leaflets: https://www.nbt.nhs.uk/our-services/a-z-services/respiratory-medicine/respiratory-patient-information/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-ebus-tbna