Evolution of transbronchial needle aspiration - a hybrid method.

Conventional Transbronchial Needle Aspiration (C-TBNA) has been around for three decades, however it is still underutilized. Recent development of Ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) renewed the interest and confident of TBNA. In short five years, it has proven to be a more attractive and reliable method than standard TBNA. Without adequate C-TBNA training is a key factor to make this useful technique to lose its competitive edge. This paper shared a junior pulmonary fellow's C-TBNA learning experience to summarize the indication, anatomy, instruments and technique, and our improvement of current and the future of TBNA. With systemic training program including slides presentation, video demonstration and hands on practice on a bronchial tree model, the correct lymph nodes of every stations would be able to punctured successfully. More importantly, this is the first time to describe a hybrid method of C-TBNA inspired by EBUS-TBNA, which will make the conventional technique more reliable and dependent in the future.