title: A novel technique of needle setting for curvilinear endobronchial ultrasound: Improved efficiency with no cost.
abstract: BACKGROUND
  Standard instructions for biopsy using the convex curvilinear endobronchial ultrasound scope include visualization and adjustment of the sheath housing the biopsy needle before every puncture. In our practice, we pre-set this relationship before inserting the endobronchial ultrasound scope and leave it fixed for every puncture.
  
  
  OBJECTIVE
  We postulated that this approach is more efficient than repeated re-adjustment and aimed to show that it would not increase the frequency of endobronchial ultrasound scope damage.
  
  
  METHODS
  Retrospective review of every biopsy using the endobronchial ultrasound scope over a 6-year period with documentation of damages and costs.
  
  
  RESULTS
  There were 15 scope damages out of 1792 procedures (0.8%). Eight damages were determined to be due to needle damage, one due to patient bite, three due to Williams airway abrasions, and three were camera failures. All damages occurred during the first 5 years of the study. Costs totaled US$138,725, for an average of US$23,120 per year. This rate of damages appears to be similar to or lower than that reported when standard instructions are followed.
  
  
  CONCLUSIONS
  Pre-setting of the biopsy needle when the endobronchial ultrasound scope is used leads to greater efficiency and no increase in scope damages.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Meena
authors.affiliation: Division of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Ayoub
authors.initials: A
authors.lastname: Innabi
authors.affiliation: Division of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Bashar
authors.initials: B
authors.lastname: Alzghoul
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Thaddeus
authors.initials: T
authors.lastname: Bartter
keywords: Respiratory medicine; cost; endobronchial ultrasound; needle setting; scope damage