Abstract
Over the last twenty years rapid technological progress has been observed affecting the medical field and especially the lung endoscopy with a remarkable contribution to diagnostic and therapeutic methods. The new endoscopic techniques have changed the course of the diagnostic process and clinicians are demanded to adopt the comprehensive skills required to perform these new bronchoscopic approaches: morphology diagnostics, staging methods, microinvasive procedures (e.g. bronchial thermoplasty, ELVR...) together with intensive care management.
Rapid development in the areas of bronchoscopic optical reach was achieved as Autofluorescence, Narrow Band Imaging and more precise optical outputs were adopted for endobronchial diagnostics. On other hand the diagnosis of parenchymatous peripheral lung lesions has presented other challenges.
I have had the privilege to be involved in the development of a navigation technology for bronchoscopy in order to reach these peripheral lung lesions. In addition, we are witnessing the increasing use of ultrasound for peripheral lesion location and mainly for mediastinal lymph node sampling for staging and diagnosis.
The changing paradigm of lung cancer screening, which has been applied in the USA since 2014 and which will be soon adopted in Europe will increase the demand on precise biopsy methods. The next twenty years will be an age of managing (solitary) pulmonary nodules.
Application and development of navigation techniques will be in this context important part of pulmonary endoscopy