Hello abhi070782. Thank you for using Healthcare Magic services Both bronchoscopy with transthoraccic needle aspiration (tna) and Mediastenoscopy with biopsy with biopsy are acceptable methods of conducting lung biopsy. Bronchoscopy with tna is usually done through the use of a light instrument (bronchoscope), inserted through the mouth or nose and into the airway to remove a lung tissue sample. The doctor will spray a numbing drug (anesthetic) in your mouth and throat. If the bronchoscopy is done through the nose, numbing jelly will be placed on one nostril. Inserting the bronchoscope will make you cough at first. The coughing will stop as the numbing drug begins to work. When the area feels thick, it is numb enough. You will likely get drugs through a vein (intravenously) to help you relax. Only rarely will you be asleep under general anesthesia. Mediastinoscopy with biopsy is a procedure in which a lighted instrument (mediastinoscope) is inserted in the space in the chest between the lungs (mediastinum), and tissue is taken (biopsy) from any unusual growth or lymph nodes. You will be given general anesthesia so that you are asleep and do not feel any pain. A tube (endotracheal tube) is placed in your nose or mouth to help you breathe.A small surgical cut is made in the neck. A device called a mediastinoscope is inserted through this cut and gently passed into the mid-part of the chest.Tissue samples are taken of the lymph nodes around the airways. The scope is then removed and the surgical cut is closed with stitches. The risk associated to mediastenoscopy with biopsy are puncturing the esophagus, trachea, or blood vessels. In some circumstances, this can lead to potentially fatal bleeding. The risk associated with bronchoscopy with TNA are Bleeding from biopsy sites, Infection. There is also a small risk of:Arrhythmias, Breathing difficulties, Fever, Heart attack, in people with existing heart disease, Low blood oxygen, Pneumothorax, Sore throat From this, you can see that both procedures have their own advantages and disadvantages. Generally speaking, both procedures are almost always successfully done. The final choice to determine which procedure should be done depend entirely on you as the recipient. Hope this is going to be of help to you.