Fig. 1

Transbronchial cryobiopsy using the two-scope technique for a peripheral pulmonary lesion. After passing the cryoprobe to the target lesion, the bronchoscope’s tip is wedged and fixed into the involved bronchus under X-ray fluoroscopy by the operator (arrowhead) (a). The bronchoscope for cryobiopsy is detached from the light source while the operator (arrowhead) keeps the cryoprobe with the bronchoscope in place, and an assistant (arrow) connects the second thick scope for hemostasis to the light source and suction tube (b). Cryobiopsy is performed under fluoroscopic guidance by the operator (arrowhead), and an assistant (arrow) immediately inserts the second thick scope through the endotracheal tube (c). An assistant controls bleeding, and the patient is simultaneously rotated to the biopsy-side down lateral decubitus position (d)