How It Is Done
A needle or bronchoscope biopsy can be done without staying in the hospital. An open biopsy requires a hospital stay for at least a few days. For a video-assisted (VATS) biopsy, you may need to stay overnight in the hospital.
You may be asked to remove dentures, eyeglasses or contact lenses, hearing aids, a wig, makeup, and jewelry before the biopsy. You will empty your bladder before the biopsy. You will need to take off all or most of your clothes. (You may be allowed to keep on your underwear if it does not interfere with the biopsy.) You will be given a cloth or paper covering to use during the biopsy.
A chest X-ray is usually taken after a lung biopsy to look for any problems related to the biopsy.
A bronchoscopic biopsy is done by a doctor who specializes in lung problems (pulmonologist or a thoracic surgeon). A thin, lighted tool called a bronchoscope is inserted through the mouth or nose and into the airway. The doctor uses the bronchoscope to remove a lung tissue sample.
Your doctor will use a CT scan, ultrasound, or fluoroscopy to guide the biopsy needle. The place where your doctor inserts the needle is cleaned first with an antiseptic solution and draped with sterile towels. Your doctor will give you a local anesthetic to keep you from feeling any pain when the needle is inserted into your chest.
Your doctor will then make a small puncture and ask you to hold your breath while the biopsy needle is inserted into your lung. It is very important to avoid coughing or moving while the needle is in your chest.
After the desired amount of tissue is collected, the needle is removed and a bandage is placed over the puncture site. Your care team will position you so that the needle puncture site can seal up. You will need to stay in this position for at least an hour.
Open biopsy and video-assisted thoracoscopic surgery (VATS)
An open biopsy is done by a chest (thoracic) surgeon or a general surgeon. You will be given a general anesthetic by an anesthesiologist. There may also be one or more assistants in the room.
You will be given a sedative to help you relax about an hour before the biopsy. You will have an intravenous line (IV) placed in a vein.
An incision is made between the ribs over the area of lung where the tissue sample is to be collected. A scope called a thoracoscope may be passed through this incision to view the surface of the lung and to remove a sample of lung tissue. A larger incision will be made if an open biopsy is needed to remove a tissue sample.
After the tissue sample is collected, your doctor will insert a drainage tube (chest tube) into the area and close the incision with stitches. One end of the tube will be in the space next to your lung. The other end will be sticking out of your chest and connected to a collection container. The chest tube helps re-expand your lung. The chest tubes will be removed when the drainage from your chest has stopped and no air is leaking from your chest incision, usually in a few days. Your stitches will be removed in 7 to 14 days.
Video-assisted thorascopic surgery (VATS) uses smaller incisions and takes less time to recover from than an open biopsy. But VATS may not be available in your area. You may need to travel to a regional medical center for this test.
How long the test takes
Bronchoscopy and a needle biopsy usually take 30 to 60 minutes. You will be in the recovery room 1 to 2 hours.
An open biopsy usually takes about an hour. Then you will be taken to the recovery room for about an hour. You will then be taken to your hospital room.
A video-assisted thoracoscopic surgery (VATS) takes 1 to 2 hours.