Fortis Hospital, Bannerghatta Road, has marked a significant milestone in advanced pulmonary care by successfully performing Karnataka’s first navigation-based bronchoscopy and lung biopsy. The cutting-edge procedure enabled the early diagnosis of suspected lung cancer in a 65-year-old woman and was conducted using the Synapse 3D Navigation System by Fujifilm.

The procedure was carried out by the Interventional Pulmonology team led by Dr. Srivatsa Lokeshwaran, Director – Interventional Pulmonology and Lung Transplantation.

The patient had initially presented with symptoms of cough and fever and was undergoing treatment for a lower respiratory tract infection. During routine evaluation, a chest X-ray revealed an abnormal shadow, prompting further investigation through a CT scan. The scan identified a 2-centimetre lung nodule in the right middle lobe, which appeared suspicious and required a biopsy for definitive diagnosis.

Traditionally, such lung nodules are sampled using a CT-guided transthoracic needle biopsy, where a needle is inserted through the chest wall into the lung. While effective, this approach carries risks including pneumothorax (lung collapse), which can occur in up to 20 percent of patients, as well as bleeding. These complications may lead to longer hospital stays and increased treatment costs. In rare cases, there is also a theoretical risk of ‘tumor seeding,’ where cancer cells may spread along the needle track, though this occurs only in a very small fraction of cases.

In contrast, navigation-based bronchoscopy allows doctors to access the lung nodule through the natural airway, eliminating the need to puncture the chest wall. This minimally invasive technique improves precision, reduces complications, and enhances overall patient safety.

Explaining the advantages of the technology, Dr. Srivatsa Lokeshwaran said, “Approaching the lung nodule through the natural airway is much like entering a house through the front door instead of breaking in from behind. It greatly reduces complications and allows us to obtain multiple high-quality tissue samples, which is crucial in today’s era of personalised and targeted cancer therapy.”

He further noted that the navigation-based approach significantly improved procedural efficiency. “We were able to reach the lung lesion in less than two minutes, compared to the conventional approach which can take over 30 minutes, while also significantly lowering radiation exposure,” he said. The procedure was completed successfully, and the patient was discharged with advice for regular follow-up.

Commenting on the development, Dr. Ananth Rao, Vice President and Business Head, Fortis Hospitals Bengaluru, said the introduction of navigation-based bronchoscopy reflects the hospital’s continued investment in advanced technologies aimed at improving patient safety and clinical outcomes. “This advancement strengthens our commitment to early cancer detection, precision diagnosis, and compassionate care for patients across the region and beyond,” he said.

Globally, most lung nodules are detected incidentally. For individuals at high risk—particularly those with a strong family history of lung cancer or a significant smoking history—low-dose CT screening remains the gold standard. Large international studies, including the National Lung Screening Trial in the United States, have shown that low-dose CT screening can reduce lung cancer mortality by up to 15 percent.

However, experts note that lung cancer screening in India presents unique challenges due to the high prevalence of tuberculosis, which frequently results in benign lung nodules that can resemble cancer, complicating diagnosis.

The successful adoption of navigation-based bronchoscopy in Karnataka marks a notable step forward in the state’s efforts toward earlier and safer lung cancer diagnosis.