Tests & Procedures

A bronchoscopy is a procedure that uses a bronchoscope (a thin, flexible tube) with an ultrasound device. It is inserted through your mouth and down into your throat and trachea. This allows the surgeon to examine your airways – from your nose down into your lungs. A mediastinoscopy uses a mediastinoscope (a thin tube with a light and camera) to look at the mediastinum (the areas in your chest between your lungs). The mediastinoscope is inserted through a small incision in your neck. See the pictures below.

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A bronchoscopy and mediastinoscopy procedure allows your surgeon to :

• Check for lung disease, infections, and cancer.

• Evaluate the size or spread of cancer.

You will be sedated (put to sleep) for this procedure. During this procedure, the surgeon removes a small amount of your tissue or lymph nodes (glands). The tissue is sent to a laboratory for testing. The tissue may be benign or malignant. Benign means it is not cancer. Malignant means it is cancer.

A CT Scan image is used to guide a needle into the area of your body that is to be biopsied. This needle is used to remove a small amount of your tissue that will be tested for abnormal cells.

On the day of your CT Guided Biopsy,

• You will check in at reception desk of the Diagnostic Imaging department. The Diagnostic Imaging department is located in the G-wing on the main floor of the hospital.

• Bring your health card and a list of your medications with you.

 

Having your CT Guided Biopsy

​You will lie down on the CT scanner bed. An intravenous (IV) line will be put into one of your veins. Medications will be given to you through your IV to help you relax and keep you comfortable. You will be awake while your biopsy is done.

The radiologist (X-ray doctor) will use the images taken with the CT Scan to guide a small needle to the area of your body that is to be biopsied. This area is cleaned and then frozen (numbed) with an injection of a local anesthetic. The Radiologist will insert the needle into the area to be biopsied.​

Small samples of your cells or tissue will be removed. This is not painful but you will feel some pressure as these samples are taken. This area will be covered with a dressing. It will take about an hour for you to have your biopsy done.

You will stay in the hospital for about 2 to 3 hours after your CT Guided Biopsy. You may have a chest x-ray again before you go home. The nurse will give you any instructions you need before you go home

A bronchoscope (a thin, flexible tube) with an ultrasound device is put into your mouth and into your trachea during an EBUS procedure. See the picture below. This allows your doctor to see inside and around your:

• Trachea (windpipe)

• Mediastinum (the space between your lungs)

• Lungs

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During the EBUS procedure, small samples of your lymph nodes may be removed (biopsies). This procedure is used to diagnose lung cancer, infections, and other diseases that cause lymph nodes in your chest to grow.

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On the day of your EBUS procedure, 

• Continue to drink clear fluids. This includes water, black coffee or tea (you may add sugar or sweetener but no milk or cream), sports drinks (no red or purple), carbonated drinks, pulp free fruit juices (no orange juice). Stop drinking fluids 3 hours before the scheduled time of your EBUS procedure.

• Take your regular medications (unless your doctor or nurse tells you something different).

• Bring your health card, a list of your medications, and medications you need to take while you are at the hospital with you. 

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Having the EBUS Procedure

You will be lying on a stretcher for this procedure. An intravenous (IV) line will be put into one of your veins. Medications will be given to you through your IV. These medications will help you relax and keep you comfortable. The doctor will spray the back of your throat with an anesthetic (freezing). A bronchoscope (a thin, lighted tube) is put through your mouth and down into your airway. The bronchoscope allows your doctor to see the lymph nodes in your chest so they can take biopsies.

A PleurX™ drainage catheter is soft silicone rubber tube inserted (put) under the skin in your chest and into the space around your lung. This drainage catheter allows the buildup of fluid to drain out before it becomes uncomfortable for you. It will be inserted by a respirologist at the Durham Regional Cancer Centre.

This is a picture of a PleurX™ drainage catheter:

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A pleural effusion is the buildup of fluid between your lungs and your chest wall. This buildup of fluid may make you feel short of breath (have difficulty breathing).​

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On the day of your drainage catheter insertion, 

• Bring your health card and a list of your medications with you.

• It is helpful to have someone come with you to this appointment.

• You will meet with a care coordinator from Ontario Health atHome to plan for a visiting nurse to see you in your home.

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You will be awake when the drainage catheter is inserted. Your skin will be cleaned with an antiseptic solution in the area where the drainage catheter is inserted. This same area will be numbed with an injection of an anaesthetic medication. You will feel the needle stick and then some mild burning. This needle has medication in it to freeze the area so you do not feel pain when the drainage catheter is inserted. Your drainage catheter will be put in through a small incision into your skin and into the space around your lung. A second small incision will be made where the drainage catheter is inserted. Your drainage catheter will be kept in place with stitches. The stitches will be taken out when the area is healed in about 10 to 14 days. A waterproof dressing will be put on over the small incisions. A label with the contact information for the Thoracic Diagnostic Assessment (DAP) Program will be placed on the waterproof dressing.

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A visiting nurse from Ontario Health atHome will come to your home the day after your drainage catheter is inserted. The visiting nurse will drain the drainage catheter as ordered by the respirologist. This will be about 2 to 3 times a week.

A thoracentesis is a procedure that allows the buildup of fluid between your lungs and chest wall (called a pleural effusion) drain out. This buildup of fluid can make you feel short of breath (have difficulty breathing).

 

A thin needle with a small tube attached to it is placed in between your ribs and into the space around your lungs. The fluid drains out through the small tube. Having a thoracentesis will make it easier for you to breathe. It also allows your doctor get a sample of the fluid for testing.​​​​​​​​

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On the day of your thoracentesis, 

• Drink fluids and eat your normal diet before your thoracentesis. You do not need to ‘fast’ for a thoracentesis.

• Plan to have someone come with you to this appointment. This is not needed but may be helpful for you.

• Bring your health card and a list of the medications you are taking.

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Having your thoracentesis

You will be asked to change into a hospital gown. The doctor and nurse will explain how a thoracentesis is done and answer your questions. You will be awake during your thoracentesis. A nurse will care for you while you have your thoracentesis. You will sit at the side of the bed with your arms resting on a table and the doctor will use an ultrasound machine to see the fluid around your lung. An area of skin on your back will be cleaned with an antiseptic solution. You will receive two needles. The first needle has medication in it that freezes (numbs) the area so you do not feel the thoracentesis needle going in. The thoracentesis needle has a small tube attached to it. The fluid drains out through this small tube and into a container. The draining of the fluid may cause you to cough. The needle and small tube are removed after the fluid has drained out and a small dressing is placed over the site where the fluid drained out.

Endoscopy procedures include: bronchoscopy and gastroscopy. Your surgeon will tell you what procedure you are having.

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The day before your endoscopy procedure, 

• Do not eat or drink anything after midnight the day before your procedure. This includes water, gum and candy.

• Do not drink alcohol for 24 hours before your procedure.

• Do not smoke for 24 hours before your procedure.

• If you take medication to manage diabetes – do not take this medication after midnight the day before your procedure.

 

An adult must drive you home from the hospital and stay with you for 24 hours. Your procedure will be cancelled if you have not planned for this.