Transbronchial needle aspiration (TBNA) is an important technique for bronchoscopists. Although endobronchial ultrasound transbronchial needle aspiration (EBUS) is more sensitive overall, TBNA is still recommended for patients with bulky mediastinal lymphadenopathy. In addition TBNA is cheaper and faster than EBUS and can be performed during a normal flexible bronchoscopy. To master the art of TBNA extensive knowledge of the bronchial and mediastinal anatomy is required, as well as the necessary skills for adequate lymph node sampling. For novices it is especially difficult to determine the right location to sample a lymph node. The TBNA app is designed to familiarize you with a concept that is easy to apply and will help you to determine the right location in any patient. Central in the TBNA app is the mediastinal and hilar lymph node map. When tapping one of the lymph node stations a sequence of CT and bronchoscopy images is shown. This sequence of five images will take you from the CT scan to the actual bronchoscopy images step by step. A second tab boundaries shows you the boundaries of the lymph node stations on the map.
This app is developed by the Bronchoscopy Foundation, which is an educational platform founded by interventional pulmonologists from the Royal Brompton Hospital in London (Pallav Shah) and the VU University Medical Center in Amsterdam (Hans Daniels & Thomas Sutedja). On the website (www.bronchoscopyfoundation.com) you can find more information about this foundation and about our bronchoscopy courses. For further reading on TBNA we refer to the book Flexible Bronchoscopy by Pallav Shah.