Single Anesthesia Bronchoscopy and Resection (SABR)

What Is Single Anesthesia Bronchoscopy and Resection (SABR)?

Single Anesthesia Bronchoscopy and Resection (SABR) is an innovative surgical approach that combines two key procedures—diagnostic bronchoscopy and therapeutic lung resection—into one operation under a single round of anesthesia for patients meeting specific criteria.

A bronchoscopy uses a thin, flexible scope to examine the airways and collect tissue samples, while a lung resection involves removing a part of the lung containing abnormal tissue or cancer.

By combining both steps into a single surgical session, SABR streamlines care, reduces risk, and speeds up recovery.
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Why Is It Done?

SABR is primarily used to diagnose and treat early-stage lung cancer or suspicious lung nodules in a more efficient way.

Traditionally, bronchoscopy and lung surgery are scheduled on separate days, with days or weeks in between. SABR eliminates that wait. If a suspicious mass is found during bronchoscopy, the surgical team can immediately proceed to remove it. This method is especially beneficial for patients who are medically fit for surgery and where timely intervention improves outcomes.

Studies have shown that SABR can reduce delays in care and may improve long-term survival in select patients with operable non-small cell lung cancer (NSCLC).

Who is Eligible for SABR?

SABR is best suited for patients with a suspicious lung nodule or early-stage non-small cell lung cancer (NSCLC) that appears operable on imaging but has not yet been biopsied. Candidates must be healthy enough to undergo both bronchoscopy and lung surgery during one procedure under general anesthesia. This includes having stable heart and lung function.

SABR is ideal for patients at risk of delays in diagnosis or treatment, where acting quickly may improve outcomes.

A multidisciplinary team will evaluate each case to ensure SABR is the safest and most effective option.

If a patient is scheduled for SABR, they give consent to both procedures prior to going under anesthesia for the bronchoscopy.

During the Procedure

During a SABR procedure, patients are placed under general anesthesia.

The first part of the procedure is a bronchoscopy performed by a pulmonologist in the bronchoscopy suite, in which a small camera is used to examine the lungs and obtain biopsy samples.

If the tissue samples test positive for cancer, the patient is taken directly to the OR where the thoracic surgery team proceeds immediately with lung resection—most commonly a wedge resection or lobectomy—removing the abnormal tissue. This is often done using minimally invasive techniques such as video-assisted thoracoscopic surgery (VATS) or robotic-assisted surgery for greater precision and faster healing.

When the patient awakes from anesthesia to learn the biopsy was positive for cancer, the nodule or tumor has already been removed.

After the Procedure

Recovery from SABR varies based on the extent of the size of the tumor and resection. Most patients spend several days in the hospital and are encouraged to walk and use breathing devices to help expand the lungs.

Pain is managed with medication, and the care team closely monitors breathing and oxygen levels.

Pulmonary rehabilitation may be recommended to help rebuild strength, improve lung function, and reduce the chance of complications.

With SABR most patients experience a shorter overall treatment timeline and quicker return to daily activities compared to those undergoing staged procedures.

As with any surgery, SABR carries some risks.

These may include bleeding, infection, prolonged air leaks, breathing problems, or adverse reactions to anesthesia.

However, combining both procedures into one session avoids repeated exposure to anesthesia and reduces the risk of delays between diagnosis and treatment. Minimally invasive techniques used in SABR can also lower the risk of complications and speed up recovery time.

Riverside’s SABR team includes pulmonologists from Riverside Pulmonary & Sleep Specialists and thoracic surgeons from Riverside Thoracic & Cardiovascular Surgical Specialists.

If you are a patient in the Lung Nodule Clinic, your care team will work with you to determine if you may be eligible for SABR.

If you or a loved one has been diagnosed with a lung nodule or early-stage lung cancer and you are interested in the SABR approach, please contact Riverside Pulmonary & Sleep Specialists at 757-534-5454.