Are difficulties during transbronchial lung biopsy/brushing through a fiberoptic bronchoscope based on the bronchial anatomy?
Some of the difficulties encountered during transbronchial lung biopsy through a flexible bronchofiberscope are due to anatomical reasons, namely the branching angles of some subsegmental bronchi from their mother bronchi are large, and differences in branching angles during respiration may also be large. This makes insertion of forceps difficult. We have sometimes experienced difficulties reaching the target lesion during a transbronchial approach. Which subsegmental bronchi make transbronchial lung biopsy/brushing difficult, and are such difficulties due to anatomical reasons? To answer these questions, we firstly surveyed 10 bronchologists regarding which five subsegmental bronchi they considered to be the most difficult for transbronchial biopsy/brushing. We then measured the branching angles of subsegmental bronchi in 106 cadaver lungs. Finally, in six volunteers, we also measured differences in branching angles of the subsegmental bronchi between the point of forced inspiration a
