Where Patients Can Access EBUS-Guided Needle Aspiration
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is performed in specialized bronchoscopy suites at hospitals and medical centers with trained pulmonologists or interventional pulmonologists, typically as an outpatient procedure. 1
Facility Requirements and Settings
EBUS-TBNA is available at tertiary referral centers and university hospitals that have the specialized equipment and trained personnel to perform this minimally invasive procedure. 2 The procedure requires:
- Dedicated bronchoscopy suites equipped with linear EBUS bronchoscopes that incorporate ultrasound transducers at the scope tip 1
- Trained operators including pulmonologists, interventional pulmonologists, or thoracic surgeons who have completed approximately 40 supervised procedures and are familiar with ultrasonic imaging 3
- Cytopathology support, ideally with rapid on-site evaluation (ROSE) capabilities, though ROSE is not mandatory for performing the procedure 1
Outpatient vs. Inpatient Procedures
The vast majority of EBUS-TBNA procedures (97%) are performed in the outpatient setting, making this an accessible option that does not require hospital admission. 4 This can be done with either:
- Moderate sedation (conscious sedation)
- Deep sedation (both are acceptable approaches per guidelines) 1
The procedure does not typically require general anesthesia, further supporting its feasibility as an outpatient procedure. 1
Finding a Qualified Provider
Patients should seek facilities where:
- Bronchoscopists have validated EBUS skills assessed through objective competency testing 1
- Simulation training programs are available, indicating institutional commitment to quality (low or high-fidelity simulation should be incorporated in training) 1, 3
- The institution performs sufficient volume to maintain operator proficiency, as EBUS-TBNA has a diagnostic yield of 93% with 100% specificity when performed by experienced operators 1
Geographic Availability
While the evidence does not specify exact geographic distribution, EBUS-TBNA is now widely adopted at:
- University-affiliated medical centers 2
- Tertiary care hospitals with pulmonary disease programs 2
- Comprehensive cancer centers where lung cancer staging is routinely performed 1, 3
The American College of Chest Physicians' AQuIRE registry captured data from six US institutions performing 853 EBUS-TBNA procedures over 12 months, indicating this technology is established at major medical centers. 1
Important Considerations
Patients should specifically request EBUS-TBNA rather than conventional TBNA, as EBUS guidance provides superior diagnostic yield (93% vs. 76% for conventional TBNA) and 100% specificity. 1 The procedure can access mediastinal lymph node stations 2L, 2R, 4L, 4R, 7, and hilar stations 10-12, making it the preferred first-line approach over surgical staging for lung cancer diagnosis and mediastinal evaluation. 1, 3