Display Patient Information Leaflets

Date issued: November 2024  

For review: November 2026 

Ref: A-660/ED/Oncology/Electromagnetic navigational bronchoscopy (ENB)

PDF: Electromagnetic navigational bronchoscopy (ENB).pdf [pdf] 223KB

What is ENB?

An Electromagnetic Navigational Bronchoscopy (ENB) is a procedure that uses electromagnetic, GPS-like technology, to examine your lungs. This is completed under general anaesthetic. It is more accurate than a normal bronchoscopy and can reach more areas of the lungs. It is used to biopsy lung nodules (remove some tissue) to help determine what they are, and whether any further treatment is needed.

Why do I need this procedure?

You may have been referred for an ENB if an area of abnormal tissue (nodule) was detected on a chest X-ray or CT scan. Most lung nodules are nothing to worry about, but some can be a sign of early lung cancer. It is important to find out what the nodules are, so we can decide on the right treatment for you. 

What happens before? 

You will have a pre-assessment appointment in the hospital. This will include having MRSA swabs, blood tests, ECG, chest X-ray and a full set of observations. We also aim to answer any questions you may have.

Antiseptic skin wash will be provided to be used before your procedure. You will need to wash your whole body and hair and this will help prevent infections.

Preparations

You will need to stop any prescribed blood thinners. Different medications need to be paused for different durations prior to the procedure. You will be informed at your pre-assessment when to stop yours.

It is vital that you do not have any food for 6 hours before your procedure. You can have water up to 2 hours before your procedure. 

Who will be at your procedure?

A consultant chest physician and/or a thoracic surgeon, an anaesthetist, nurses, operating department practitioner and recovery staff.

Where will your procedure be?

Please attend Postbridge ward Level 4, where you will then be taken to the thoracic theatre.

The Procedure 

Your procedure will start by being taken to a room where an anaesthetist will give you the general anaesthetic. Once you are asleep, you will be transferred onto a table where you will lie on a special board that creates an electromagnetic field around your chest.

A bronchoscope (a long, flexible tube with a bright light at the end) is guided down into your lungs. A thin catheter with a sensor at the end is then passed through the bronchoscope. Using a map based on your previous CT scans, computer software and the electromagnetic field, the doctor directs the scope through your lungs to the nodules (a bit like the SatNav in a car).

Additional X-rays are then done to ensure the scope is as close to the lung nodule as possible. Biopsies (small samples of body tissue) are then taken from inside the lungs. 

Potential complications after an ENB include: 

• Damage to teeth.

• Chest infection (moving around early on will help to prevent this).

• Temporary narrowing of your airways (this is called bronchospasm and may cause you to cough and feel wheezy).

• A collapsed lung (this is called pneumothorax). If this happens, you may need to stay in hospital and may need a tube inserting into the space around your lungs to allow air to escape.

What happens after?

After the procedure you will be taken to the recovery unit where the recovery nurse will monitor you until you are safe to be discharged home or admitted to a ward overnight.

You will need to arrange for someone to stay with you.

The general anaesthetic can affect your memory, concentration and reflexes for a day or two, so it’s important you arrange for a responsible adult to accompany you home and stay with you for 24 hours after the procedure, if you’re allowed to go home. If no-one is available, please let us know and we will arrange for you to be admitted to hospital. We try very hard not to admit people after an ENB, but if required, you would be admitted to the thoracic wards. Please pack an overnight bag including your regular medication and bring it into hospital with you just in case you need to stay. We recommend leaving any valuables at home.

After your general anaesthetic

In the first 48 hours after your general anaesthetic, you may feel more sleepy than usual, and your judgement may be impaired. You are advised not to:

• Drive (your insurance company will have its own conditions for when you are insured to start driving again, so it is important you check your policy).

• Drink alcohol.

• Work.

• Exercise.

• Handle machinery (including an oven or hob).

• Sign any legal documents.

If you experience any pain or discomfort in your lower legs (calves), or they become swollen, contact your GP for advice.

Common side effects

Tiredness.

• A sore throat, (this should improve over a few days, and you can take some over the counter pain relief medication to ease your symptoms).

• A cough which brings up a small amount of blood (this should stop after a few days).

Please seek medical advice if you get any of the following symptoms: 

• Worried about the amount of blood you are coughing up.

• Increased shortness of breath.

• Vomiting.

• High temperature (38°C or above).

Results

We will not be able to give you your results on the day of the procedure, as it can take time for the results to be available. Once these results are available, they will be discussed at the weekly team meeting. You will be contacted with an appointment to come in and discuss the outcomes. 

Any further information about your ENB please contact your lung specialist nurses on 01752 432383.